acceptance model of intuitive eating with younger and older women
DESCRIPTION
An Intuitive Eating study on nearly 700 women showed that the constructs of Intuitive Eating apply to older and younger women across the lifespan. Notably, body appreciation predicted the ability for women of varied ages to eat intuitively. This study is a dissertation by Casey L. Augustus-Horvath from Ohio State University, supervised by Tracy Tylka, PhD, who created and validated the Intuitive Eating Scale.More Resources on Intuitive Eating:Intuitive Eating Professionals-LinkedIn http://www.linkedin.com/groupRegistration?gid=1806863Intuitive Eating Resources http://bit.ly/5pikMR www.IntuitiveEating.orgIntuitive Eating Skills Training for Health Professionals http://intuitiveeatingpro.com/TRANSCRIPT
A TEST AND EXTENSION OF AN ACCEPTANCE MODEL OF INTUITIVE EATING WITH YOUNGER AND OLDER WOMEN
DISSERTATION
Presented in Partial Fulfillment of the Requirements for
the Degree Doctor of Philosophy in the Graduate
School of The Ohio State University
By
CASEY L. AUGUSTUS-HORVATH, M.A.
*****
The Ohio State University 2008
Dissertation Committee:
Approved by Professor Nancy E. Betz, Advisor Professor Tracy L. Tylka, Advisor
_________________________________ Professor Don M. Dell Advisor Graduate Program in Psychology
ii
ABSTRACT
An acceptance model of intuitive eating has been empirically supported with
traditionally-aged female undergraduates (Avalos & Tylka, 2006). The present study
extends this research by testing its tenets with women aged 18-24 (n=307) and women
aged 25-79 (n=381). Latent variable structural equation modeling (SEM) with multiple
group analysis was used to test model invariance and evaluate the proposed pathways
among this model's core constructs (general unconditional acceptance, body acceptance
from others, body function, body appreciation, intuitive eating). Findings were consistent
for both groups of women. After controlling for body mass, general unconditional
acceptance (i.e., perceived social support) directly predicted body appreciation by others.
Body appreciation by others predicted body function and body appreciation. Body
function, then, predicted body appreciation and intuitive eating. Finally, body
appreciation predicted intuitive eating for participants of the present study. Analyses also
indicated model invariance. These results replicated and extend findings of Avalos and
Tylka (2006), suggesting that the acceptance model extended to women older than
traditionally-aged undergraduates; however, the core constructs may be associated at
somewhat different strengths for older and younger women.
iii
Dedicated to my amazing blessings- my family, friends, mentors, and especially my husband
iv
ACKNOWLEDGMENTS
I wish to thank my advisor Dr. Tracy Tylka for her constant support, positive
unconditional regard as an advisor, patience, encouragement, challenge, and inspiration
throughout this process. Her guidance and mentoring has created a rewarding journey
and a lesson in dedication, perseverance, and self-efficacy.
I wish to thank my advisor Dr. Nancy Betz for teaching lessons learned as a solid
researcher, as well as for her assistance in combating the null environment.
I wish to thank Dr. Don Dell for offering a balance of support and challenge
throughout my undergraduate and graduate careers, as well as for teaching us to be
highly-competent, ethical, and informed professionals.
I wish to thank my husband for standing beside me, for providing me strength.
I wish to thank my family, friends, and mentors for their prayers, understanding,
and encouragement.
v
VITA
April 28, 1981 . . . . . . . . . . . . . . . . . . . . . Born � Springfield, Ohio 2003��������������..B.S. Psychology The Ohio State University 2005���. . . . . . . . . . . . . . . . . . . . . . . M.A. Psychology The Ohio State University 2002-2003������������.Senior Honor�s Thesis, The Ohio State
University
2002-2003������������..Researcher, Multifamily Psychoeducation Group Study, The Ohio State University
2003-2005������������..Student Personnel Assistant, Walter E. Dennis Learning Center, The Ohio State University
2005-2006�����������......Student Personnel Assistant, Counseling and Consultation Service, The Ohio State University
2006-2007������������..Instructor, Department of Psychology The Ohio State University 2006-2007������������..Adjunct Instructor, Department of Psychology Ohio Dominican University 2006-2007������������..Fellow, Preparing Future Faculty Program The Ohio State University 2007-2008������������..Predoctoral Intern, Counseling Center University of Miami
vi
PUBLICATIONS
Research Publications 1. Kozee, H.B., Tylka, T.L., Augustus-Horvath, C.L., & Denchik, A. (2007). Development and Psychometric Evaluation of the Interpersonal Sexual Objectification Scale, Psychology of Women Quarterly, 31, 176-189.
FIELDS OF STUDY
Major Field: Psychology
vii
TABLE OF CONTENTS
P a g e Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii Dedication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iv Vita . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v List of Tables. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii
Chapters:
1. Introduction. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Review of the Literature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.1 Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���.10
2.2 Age in relation to body image concerns of women. . . . . . . . . . . . .. . . . . 11
2.3 Age in relation to eating disorder symptomatology. . �.... . . . . . . . . . . . .16
2.4 Summary of age in relation to body image and eating disorder concerns.. 19
2.5 A model of intuitive eating. . .. . . . . . . . . . . . . . ����������.22
2.51 General unconditional acceptance. . .. . . . . . . . . . . . . �����24
2.52 Body acceptance by others. . .. . . . . . . . . . . . . �������...28
2.53 Body function. . .. . . . . . . . . . ������������.. . . . 30
viii
2.54 Body appreciation. . .. . . . �����������. . . . . . . . . .31
2.55 Intuitive eating. . .. . . . . . . . . . . . ������������... 34
2.6 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���� . . . . �35
2.7 Purpose of the study.. . . . . . . . . . . . . ��������������.36
2.8 Hypotheses of the study.. . . . . . . . . . . . . . ������������.37
3. Method.. . . . . . . . . . . . . . ���������������������.39
3.1 Participants.. . . . . . . . . . . . . . �����������������39
3.11 Women aged 18-24 years old.. . . . . . . . . . . . . . �������.41
3.12 Women aged 25-79 years old.. . . . . . . . . . . . . . �������42
3.2 Procedure.. . . . . . . . . . . . . . �����������������...44
3.3 Measures.. . . . . . . . . . . . . ������������������..46
3.31 Perceived social support.. . . . . . . . . . . . . ��������� 46
3.32 Body acceptance by others.. . . . . . . . . . . . . . �������...48
3.33 Body function.. . . . . . . . . . . . . . ������������...48
3.34 Body appreciation .. . . . . . . . . . . . �����������.. 50
3.35 Intuitive eating.. . . . . . . . . . . . . . ������������..50
3.4 Design.. . . . . . . . . . . . . �������������������. 51
3.41 Latent variable structural equation modeling.. . . . . . . . . . . . . . ...51
3.411 Creation of measured/observed variables.. .. . . . . . . . . .52
3.412 Multiple group analysis and test of model invariance. . 53
4. Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �����������...55
4.1 Descriptive statistics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���.55
ix
4.2 Latent variable SEM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���.57
4.3 Multiple group analysis and test of model invariance. . . . . . . . . . . . . . . .61
5. Discussion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���������...63
5.1 Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ������.. �.63
5.2 Discussion of findings from latent variable SEM. . . . . . . . . . . . . . . . . �63
5.21 General unconditional acceptance. . . . . . . . . .. . . . . . . . . . . . . �65
5.22 Body acceptance by others. . . . .. . . . . . . . . . . . . . . . . . ���...68
5.23 Body function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ��..71
5.24 Body appreciation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..72
5.25 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ����...73
5.3 Discussion of multiple group analyses and test of model invariance. . . ...74
5.4 Limitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ���������..75
5.5 Future research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �������.77
References. . . . . . . . . . . . . . . . . . ���������������. . . . . . . . . . . . . 79
Appendices. . . . . . . . . . . . . . �.. . . . . . . . . . . . . . . . . �������������..86
Appendix A: Description of study hosted on website. . . . . . .. . . ... . . . . . . . . . . 86
Appendix B: Electronic mail description. . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . 88
Appendix C: Social provisions scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..�...90
Appendix D: Objectified body consciousness scale: body surveillance���...92
Appendix E: Body acceptance by others scale. . . . . . . .. . . . . . . . . . . . . �.....�94
Appendix F: Body appreciation scale. . . .�����������..��..�97
Appendix G: Intuitive eating scale. . . . . .. . . . . . . . . . . . ��������...100
x
Appendix H: Demographic information. . . . .. . . . . . . .. . . . . . ������..103
Appendix I: Tables and Figures�����������������.�..105
xi
LIST OF TABLES
Table Page
1 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body function, body appreciation, intuitive eating for women aged 18-24�..106 2 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body function, body appreciation, intuitive eating for women aged 25-79�..107 3 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body
function, body appreciation, and intuitive eating for all women in the study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ����.. . . . . . . 108
4 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for women aged 18-24��. . . . .. .. .109 5 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for women aged 25-79��. . . . . . . .110 6 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for all women in the study�. . . . . . .111 7 The relationships among latent variables based on the measurement model are presented in Table 7 for the younger group��. . . . . �. . .112 8 The relationships among latent variables based on the measurement model are presented in Table 8 for the older group�.��. . . . . �. . .114
xii
9 Means, standard deviations, and partial correlations (with body mass index controlled) among parcels for women aged 18-24. . ���. . . .116 10 Means, standard deviations, and partial correlations (with body mass index controlled) among parcels for women aged 25-79. . ���. . . .117
xiii
LIST OF FIGURES
Figure Page 1 Hypothesized model illustrating the prediction of intuitive eating.... . . 118 2 Parcel loadings for the measurement model and path coefficients for the trimmed structural model obtained by analyzing data from women 18-24 using latent variable structural equation modeling. ... ����� . . . 119 3 Parcel loadings for the measurement model and path coefficients for the trimmed structural model obtained by analyzing data from women 25-79 using latent variable structural equation modeling. . ����� . . . . 120
1
CHAPTER 1
INTRODUCTION
Scholars have garnered considerable evidence suggesting that the incidence of
body image and eating disorder concerns has significantly and dramatically risen in
Western society over the past few decades (Feingold & Mazella, 1998; Garner, 1997;
Muth & Cash, 1998). The Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV; American Psychiatric Association, 1994) includes diagnostic criteria for the
following three eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Eating
Disorder Not Otherwise Specified. According to the DSM-IV (American Psychiatric
Association, 1994), a diagnosis of Anorexia Nervosa includes the following diagnostic
criteria: a) refusal to maintain body weight at or above a minimally normal weight for age
and height (e.g., weight loss leading to maintenance of body weight less than 85% of that
expected or failure to make expected weight gain during period of growth, leading to
body weight less than 85% of that expected), b) intense fear of gaining weight or
becoming fat, even though underweight, c) disturbance in the way one�s body weight or
shape is experienced, undue influence of body weight or shape on self evaluation, or
denial of the seriousness of the current low body weight, d) in postmenarchal females,
2
amenorrhea (i.e., the absence of at least three consecutive cycles, periods that only occur
following hormone administration such as estrogen). The DSM-IV further specifies two
types of Anorexia Nervosa, which include restricting type and binge-eating/purging type
(American Psychiatric Association, 1994). A restricting type of Anorexia Nervosa may
be specified if the person has not regularly engaged in binge-eating or purging behavior
during the current episode of Anorexia Nervosa (American Psychiatric Association,
1994). A binge-eating/purging type of Anorexia Nervosa may be specified if the person
has regularly engaged in binge-eating or purging behavior during the current episode of
Anorexia Nervosa (American Psychiatric Association, 1994).
A diagnosis of Bulimia Nervosa includes the following diagnostic criteria: a)
recurrent episodes of binge eating characterized by eating an amount of food that is larger
than most people would eat during a similar discrete period of time under similar
circumstances, and feeling out of control of the eating during the episode, b) recurrent
compensatory behavior in order to prevent weight gain (e.g., self-induced vomiting,
laxative misuse, diuretics, enemas, fasting, excessive exercise), c) the binge-eating and
compensatory behaviors occur on average at least twice weekly for three months, self-
evaluation unduly influenced by body shape and weight, d) the binge-eating and
compensatory behaviors do not occur exclusively during episode of Anorexia Nervosa
(American Psychiatric Association, 1994). In addition, the DSM-IV specifies the
following two types of Bulimia Nervosa: purging type and nonpurging type. To meet
criteria for the purging type of Bulimia Nervosa, one must have regularly engaged in self-
induced vomiting or the misuse of laxatives, diuretics, or enemas during the current
3
episode of Bulimia Nervosa (American Psychiatric Association, 1994). To meet criteria
for the nonpurging type of Bulimia Nervosa, one must have regularly used inappropriate
compensatory behaviors, such as fasting or excessive exercise, but have not regularly
engaged in self-induced vomiting, or the misuse of laxatives, diuretics, or enemas during
the current episode of Bulimia Nervosa (American Psychiatric Association, 1994).
A diagnosis of Eating Disorder Not Otherwise Specified encompasses disorders of
eating that do not meet full criteria for any specific eating disorder, such as the following
instances: a) for females, all of the criteria for Anorexia Nervosa are met except that the
female has regular menses, b) all of the criteria for Anorexia Nervosa are met except that
the individual is still within a normal weight range, c) all of the criteria for Bulimia
Nervosa are met except that the individual does not meet the frequency requirement for
the binge-eating and compensatory behaviors, d) regular use of inappropriate
compensatory behaviors by a person in a normal weight range (e.g., self-induced
vomiting after the consumption of two cookies), or e) repeatedly chewing and spitting
out, but not swallowing, large amounts of food (American Psychiatric Association,
1994). Finally, one�s eating experiences may be described by a specified subtype of an
Eating Disorder Not Otherwise Specified called Binge-eating Disorder, which is
categorized by recurrent binge-eating episodes in the absence of regular use of
inappropriate compensatory behaviors (American Psychiatric Association, 1994). Many
professionals have criticized these classification systems for eating disorders as too
extreme or severe.
4
While the percentages of women meeting criteria for bona-fide, full-syndrome
clinical eating disorders are relatively small (i.e., .5% for AN, 1-3% for BN, and 2-5% for
EDNOS; American Psychiatric Association, 1994), the prevalence of eating disordered
behaviors appears to be reaching alarmingly high levels in Western society (Mintz &
Betz, 1988; Tylka & Subich, 2004). Eating disordered behavior has been associated with
health-related problems, interpersonal difficulties, high relapse rates, increased risk for
death, and impairment in health and psychosocial functioning, even if the eating
disordered symptomatology is sub-threshold and does not warrant a diagnosis of a full-
syndrome eating disorder (Herzog Dorer, Keel, Selwyn, Ekeblad, Flores, Greenwood,
Burwell, Keler, 1999; Pearson Goldklang, & Striegel-Moore, 2002). A study by Mintz
and Betz (1988) found that only thirty-three percent of women in their sample could be
classified as normal eaters, with sixty-seven percent falling somewhere between normal
and bulimic. Fortunately, researchers have recognized the need to establish a firm
foundation of theoretical and empirical literature to accompany the growing everyday
salience of body image and eating disorder concerns for women. Kashubeck-West and
Mintz (2001) identified more than 2,000 articles published on eating disorders just
between the years of 1995 and 2000. While this relatively fast-paced accumulation of
literature addressing eating disorders is promising and encouraging, the vast majority of
such research has maintained an almost exclusive pathology-based focus and relied on
convenience samples (Avalos & Tylka, 2006).
This pathology-based focus of extant literature entails examining negative
components of body image (e.g., body dissatisfaction), and eating disorder
5
symptomatology, while a more growth-based approach would shift the focus to studying
components of positive body image and adaptive eating behaviors. Such a growth-
oriented focus would be consistent with the approach of positive psychology, which
examines positive subjective experiences and individual traits associated with improved
quality of life and prevention of pathology (Seligman & Csikszentmihalyi, 2000).
Utilizing a growth-based approach to study body image and eating behaviors is also
consistent with the mission of counseling psychology, which focuses on growth, assets,
strengths, and prevention (Gelso & Fretz, 2001).
In addition, scholars such as Kashubeck-West and Mintz (2001) urged counseling
psychologists to capitalize upon the unique strength-based perspective of counseling
psychology while undertaking the study of body image and eating behaviors.
Kashubeck-West and Mintz (2001) underscored the fresh perspective that counseling
psychologists can offer to extant knowledge of eating and body image concerns.
Therefore, it is of utmost importance that counseling psychologists capitalize upon the
unique strengths of their field in order to integrate, apply, and extend existing knowledge
of eating and body image concerns.
Because the philosophical tenets of counseling psychology seem to nicely position
counseling psychologists for the study of eating behaviors and body image in general,
many researchers (e.g., Hotelling, 2001) continue to press for counseling psychologists to
call upon strengths of their training (e.g., focus on hygiology, emphasis on
multiculturalism, diversity and cultural influences, use of holistic and strength-based
approaches) in pursuit of the study of eating behaviors and body image concerns. Among
6
other strengths, counseling psychology�s growth-based focus and emphasis on cultural
influences and diversity excellently equip counseling psychologists to explore
sociocultural influences on eating behaviors as experienced by diverse populations. Their
holistic approach further aids counseling psychologists in identifying the need for, and
means by which to integrate and apply, supported models of body image and eating
behaviors with diverse populations.
Again, perhaps most pertinent to the present study are the tenets of counseling
psychology which focus on health, growth, and prevention (Gelso & Fretz, 2001) and
highlight by contrast the dearth of literature addressing adaptive eating behaviors and
positive body image. Although many researchers (e.g., Fredrickson & Roberts, 1997;
Hund & Espelage, 2005; Mazzeo & Espelage, 2002; Stice, Nemeroff, & Shaw, 1996;
Tylka & Subich, 2004) have offered theoretical frameworks for understanding how
negative constructs interact to predict eating disorder symptomatology, researchers
(Avalos, Tylka, & Wood-Barcalow, 2005; Tylka, 2006) have only recently begun to
infuse a focus of hygiology into research on body image and eating behaviors. Such
groundbreaking scholarly work is essential in order to garner a more holistic and
complete knowledge of eating disorders and body image within a larger context by
examining constructs associated with positive body image and more varied eating
behaviors.
Yet another prime opportunity and need for expanding extant research on body image
and eating behaviors is the incorporation of more diverse samples into research
paradigms. Research suggests that body image and eating disorder concerns may affect a
7
wide variety of individuals differing in age (e.g., Pliner, Chaiken, & Flett, 1990),
racial/ethnic background (e.g., Wilcox, 2006), and sexual orientation (e.g., Striegel-
Moore, Tucker, & Hsu, 1990); however, the majority of extant research on eating
disorders has relied on convenience samples drawn from college populations of
predominantly White, heterosexual young women aged 18-24 years old (Grogan, 1999;
Wonderlich, Joiner, Keel, Williamson, & Crosby, 2007).
Therefore, in addition to the dire need for research addressing positive eating
behaviors and body image, research is greatly needed to address the concerns of women
older than the traditionally-aged undergraduate (i.e., 18-24 years old). Extant literature
addressing mental health experiences of women older than the traditionally-aged
undergraduate seems to demonstrate a lack of consensus regarding potential risk and
protective factors for older women as compared to younger women (Fredrickson &
Roberts, 1997). Traditional and sociobiological theories have suggested that women may
experience a decline in well-being and an associated increase in risk for experiencing
mental health concerns around the age of 40, which such theorists attributed to the
passing of a woman�s biological usefulness (for a review, see Gergen, 1990). Feminist
theories, however, challenge the perspective that menopause is associated with negative
psychological consequences and instead posit that midlife may be a time of enhanced
well-being and protection from mental health concerns (e.g., Fodor & Franks, 1990;
Mitchell & Helson, 1990; Neugarten, Wood, Kraines, & Loomis, 1963; Parlee, 1984).
Certainly, empirical studies aiming to include women older than the traditionally-aged
8
undergraduate would complement and potentially clarify theoretical research examining
the role of aging in women�s mental health experiences.
The present study is an attempt to examine the potential role age may play in
women�s mental health experiences by exploring positive body image constructs and
adaptive eating behaviors with older and younger women. Specifically, the present study
will test posited pathways of a model based on acceptance in which certain core
constructs (i.e., general unconditional acceptance, body acceptance from others, body
function, body appreciation) are theorized to predict adaptive eating behaviors (i.e.,
intuitive eating). This acceptance model of intuitive eating was created by Avalos and
Tylka (2006) and supported in their sample of college women, but the present study aims
to test how well the model fits with a sample of older women in comparison to a sample
of younger women. It seems that at present, no study has aimed to investigate such
adaptive eating behaviors and positive body image constructs with women older than
traditionally-aged undergraduate students.
Because extant literature does not offer insight as to the generalizability of such a
predictive model incorporating positive aspects of body image and eating behaviors with
female participants aged across the adult life span, the next chapter will offer a review of
available research pertaining to: (a) age in relation to body image, (b) age in relation to
eating disorder concerns, and (c) a model of adaptive (i.e., intuitive) eating behaviors and
attitudes as applied to young college women. It is hoped that such a review will provide
a context in which to recognize the import of the present study as an attempt to apply,
9
integrate, and extend extant literature in order to provide a more comprehensive and
holistic understanding of the eating experiences of women aged across the adult lifespan.
10
CHAPTER 2
REVIEW OF THE LITERATURE
2.1 Overview
As will be discussed in more detail in this chapter, extant literature has yet to reach
agreement as to the role of age in relation to eating behaviors, attitudes, and body image.
The few studies (e.g., Greenleaf, 2005; Hill, 2003; Tiggemann & Lynch, 2001)
incorporating samples of older women have also remained pathology-focused by
applying theoretical frameworks predicting negative body image and eating disorder
symptomatology. Again, it appears that no existing study has explored models or
constructs of adaptive eating behaviors and positive body image with substantive samples
of women aged older than the traditional undergraduate. As such, the ensuing chapter
will offer a review of: (a) research addressing age in relation to body image concerns of
women, (b) research addressing age in relation to eating disorder concerns of women, and
(c) research exploring a model of positive eating behaviors and body image (i.e., an
acceptance model of intuitive eating) with female, young, traditionally-aged
undergraduates.
11
2.2 Age in Relation to Body Image Concerns of Women
Varied and rather preliminary findings have been identified within the literature
addressing age in relation to body image-related concerns. One line of research has
provided support for the notion that middle-aged and older women tend to report fewer
negative body image concerns than young women (e.g., Deeks & McCabe, 2001;
Greenleaf, 2005; McKinley, 1999; Pliner, Chaiken, & Flett, 1990; Tiggemann & Lynch,
2001). In contrast, another line of research has failed to provide support for age-related
differences in women�s body image-related concerns (e.g., Altabe & Thompson, 1993;
Ben-Tovim & Walker, 1994; Davis & Cowles, 1991; Garner, 1997; Rozin & Fallon,
1988; Tiggemann & Lynch, 2001). Both lines of research will be reviewed below.
Findings by McKinley (1999) provided support for the notion that middle-aged
women tend to report fewer body image concerns than younger women. In this study, the
body image-related constructs of body surveillance and body shame were measured in
151 undergraduate women and their middle-aged mothers (aged 38-58). Body
surveillance was measured using the Body Surveillance subscale of the Objectified Body
Consciousness Scale (OBC; McKinley & Hyde, 1996), whereas body shame was
measured using the Body Shame subscale of the OBC. Results suggested lower levels of
body surveillance and body shame for middle-aged women than for younger women of
the sample, elucidating an important age-related finding in the study of body image
concerns. McKinley (1999) suggested that this finding may mean that older women
objectify their bodies to a lesser extent than younger women.
12
A study by Greenleaf (2005) also garnered evidence in support of the notion that
older women may experience fewer negative body image concerns than younger women.
In this study, 394 women aged 18-64 were administered the Body Surveillance subscale
of the Objectified Body Consciousness Scale (McKinley & Hyde, 1996) to measure self-
objectification, as well as the Body Shame subscale of the Objectified Body
Consciousness Scale (McKinley & Hyde, 1996) to measure body shame. Results
suggested that older participants (aged 39-64) reported significantly lower levels of self-
objectification and body shame in comparison to younger participants (aged 18-30).
Greenleaf (2005) urged researchers to further examine the experiences of various body
concerns among older women.
Deeks and McCabe (2001) also found evidence to suggest that older women may
experience body image related concerns to a lesser degree than younger women. The
investigators drew from a community sample of 304 women, ranging in age from 35-65
years old, in an attempt to investigate the relationship between menopausal stage, age,
and women�s perceptions of their body image. The questionnaire completed by
participants contained the Stunkard Body Shape Figure Scale (Stunkard, Sorenson,
Schulsinger, 1980) to identify participants� ratings of their current, ideal, and societal
body shape.
Results suggested that older perimenopausal (age range 35-54) and postmenopausal
(age range 40-65) women selected larger figures as ratings of the current, ideal, and
13
societal body shape more often than the younger premenopausal women in the sample.
In their discussion, the authors stated:
Postmenopausal women seem to expect society will accept that they are not as
thin as the premenopausal women (who are also likely to be younger). However,
it is not known how this makes them feel. It is not known whether having a
slightly larger body shape is a positive or negative experience (Deeks & McCabe,
2001; p. 378).
Clearly, research needs to address the affective component (e.g., body appreciation,
body shame) related to potential age differences in women�s experiences with body
image.
Yet another study by Pliner, Chaiken, and Flett (1990) found evidence to suggest that
older women may experience fewer body image-related concerns than younger women.
The authors examined the body image-related construct of appearance importance in a
community sample of 639 Canadian participants aged 10-79 years. The construct of
appearance importance was measured with the 7-item Importance of Physical
Appearance scale (Pliner, Chaiken, & Flett, 1990). Analyses suggested a significant age
effect on appearance importance, indicating that the importance of physical appearance
was found to decrease with age.
Tiggemann and Lynch (2001) also provided empirical support indicating that older
women may endorse a lower level of negative body-image concerns in comparison to
their sample of younger women. The construct of self-objectification was measured
14
using the Self-objectification Questionnaire (Noll & Fredrickson, 1998) while the
construct of habitual body monitoring was measured with the Body Surveillance subscale
of the Objectified Consciousness Scale (McKinley & Hyde, 1996), and the construct of
appearance anxiety was measured using the short form of the Appearance Anxiety Scale
(Dion, Dion, & Keelan, 1990). Results from a sample of 322 women (aged 20-84)
indicated that all three of the aforementioned constructs significantly decreased as
participants� age increased.
In contrast to the aforementioned findings, another line of research has failed to
provide support for age-related differences in body image constructs (e.g., Altabe &
Thompson, 1993; Ben-Tovim & Walker, 1994; Davis & Cowles, 1991; Garner, 1997;
Rozin & Fallon, 1988; Tiggemann & Lynch, 2001). One such finding comes from a
study conducted by Altabe and Thompson in 1993. Altabe and Thompson (1993)
administered the Figure Rating Scale (Strunkard, Sorenson, & Schulsinger, 1983) to
measure body dissatisfaction in a sample of 283 female undergraduates aged 17-40 years
old. Findings failed to indicate any significant differences in body dissatisfaction in
relation to age.
Another study that did not produce evidence of age-related effects in relation to body
image constructs is a study conducted by Webster and Tiggemann (2003). The authors
measured the body image-related constructs of body dissatisfaction and body importance
with a modified, 17-item version of the Body Cathexis Scale (Secord & Hourard, 1953).
Participants were asked to rate body dissatisfaction and then body importance on a 5-
point Likert-type scale (1= very dissatisfied to 5 = very satisfied). The community
15
sample included 106 women aged 20-65 years. Results indicated that body
dissatisfaction remained constant across the lifespan of participants, as did body
importance; therefore, no significant age effects were found in relation to the body
image-related constructs of body dissatisfaction and body importance for this study
(Webster & Tiggemann, 2003).
Yet another study (i.e., Tiggemann & Lynch, 2001) did not uncover significant age-
related differences in body dissatisfaction. In a sample of 322 women ranging in age
from 20-84 years old, the construct of body dissatisfaction was measured using the Figure
Rating Scale (Fallon & Rozin, 1985), as well as the Body Esteem Scale (Franzoi &
Shields, 1984). The construct of body shame was measured using the Body Shame
subscale of the OBC (McKinley & Hyde, 1996). Results failed to find significant age
effects in relation to body dissatisfaction or in relation to body shame. These findings
suggested that body dissatisfaction and body shame may remain relatively stable across
the lifespan.
In addition, a study conducted by Ben-Tovim and Walker (1994) did not uncover
significant influences of age on body-related attitudes (i.e., feeling fat, body
disparagement, lower body fatness). The aforementioned body-related attitudes were
measured by administering the 44-item self-report Body Attitudes Questionnaire (Ben-
Tovim & Walker, 1991) to a community sample of 1225 Australian females aged 13-65
years. Results were found not to vary significantly with age. Ben-Tovim and Walker
(1994) interpreted these results to suggest that some body-related attitudes may be
experienced on a consistent basis as women age.
16
2.3 Age in Relation to Eating Disorder Symptomatology
As with the literature addressing age in relation to body image-related concerns,
varied findings constitute a beginning groundwork for the literature addressing age in
relation to eating disorder symptomatology. Some studies have garnered evidence for
age-related differences in eating disorder symptomatology, in that older women reported
less eating disorder symptomatology (Tiggemann & Lynch, 2001; Rand & Kuldau, 1991;
Lewis & Cachelin, 2001). Other studies have failed to find significant age-related
differences in eating disorder symptomatology (McKinley, 1999; Hetherington &
Burnett, 1994; Stokes & Frederick-Recascino, 2003). Select seminal studies will be
reviewed below.
Although a recently described study conducted by Tiggemann and Lynch (2001)
failed to find significant age differences in relation to the constructs of body
dissatisfaction or body shame, the study did produce significant age differences in
measures of eating disorder symptomatology. The construct of disordered eating was
measured using the three behavioral subscales of the EDI (Garner et al., 1983), and the
construct of dietary restraint was measured using the Revised Restraint Scale (Herman &
Polivy, 1980). This study garnered support for age-related differences in eating disorder
symptomatology by revealing that older women reported less disordered eating and
dietary restraint than younger women in the study.
A study by Rand and Kuldau in 1991 also yielded evidence for age-related
differences in eating disorder symptomatology. The construct of dietary restraint was
17
measured using Herman and Polivy�s Restraint Scale (1980) in a sample of 1211women,
aged 18-75 years old. Significant age differences were found in women�s reported
dietary restraint. Specifically, results indicated that older women (i.e., 65 and older)
reported significantly less dietary restraint than younger women (i.e., younger than 65) in
the sample.
Another study providing evidence for the argument that older women may experience
less eating disorder concerns is a study by Lewis and Cachelin (2001). The authors
measured eating disorder symptomatology (i.e., drive for thinness, bulimic
symptomatology, poor interoceptive awareness) in a sample of 125 middle-aged women
(aged 50-65) and a sample of 125 elderly women (aged 66 and older). The construct of
drive for thinness was measured using the Drive for Thinness Scale of the EDI (Garner
Olmstead, & Polivy, 1983), whereas the construct of bulimic symptomatology was
measured using Bulimia Scale of the EDI, and poor interoceptive awareness was
measured using the Interoceptive Awareness Scale of the EDI. Data indicated that the
elderly sample (66 years and older) of women reported less drive for thinness, less
bulimic symptomatology, and less poor interoceptive awareness as compared to the
younger sample (50-65 years) of women. The authors elaborated that although findings
suggested that older women may experience fewer eating disorder concerns, the older
women of the sample still reported eating disorder symptomatology well within the
normative range found in studies with traditional college-aged women. Lewis and
Cachelin (2001) then underscored the need to apply and extend extant research paradigms
18
with samples of older women, in an attempt to further elucidate similarities and
differences in experiences with eating disorder concerns.
While one line of research has suggested that older women may experience less
eating disorder symptomatology (Tiggemann & Lynch, 2001; Rand & Kuldau, 1991;
Lewis & Cachelin, 2001), another line of research findings has failed to find significant
age-related differences in eating disorder symptomatology (Hetherington & Burnett,
1994; McKinley, 1999; Stokes & Frederick-Recascino, 2003). As an example of a study
that did not yield significant age-related findings in terms of eating disorder
symptomatology, Stokes and Frederick-Recascino (2003) examined the constructs of
body esteem and eating disorder symptomatology in a sample of 144 women, aged 18-87
years old. Body esteem was measured using the 35-item Body Esteem Scale (Franzoi &
Shields, 1984), and eating disorder symptomatology was measured using the EAT
(Garner & Garfinkel, 1979). There were no significant differences in body esteem or
eating disorder symptomatology as reported by women of different ages.
A previously described study by McKinley (1999) also did not identify age-related
differences in women�s experiences of eating disorder symptomatology. While findings
did indicate age-related differences in body image-related concerns, the findings did not
indicate age-related differences in body esteem or eating disorder symptomatology.
Body esteem was measured using the Body Esteem Scale (Franzoi & Shields, 1984), and
eating disorder symptomatology was measured by having participants indicate on a 5-
point scale how often they diet and how often they engage in restrictive eating.
19
McKinley (1999) concluded that no significant differences were evidenced in the body
esteem or the eating disorder symptomatology of women of different ages.
Another study undertaken by Hetherington and Burnett (1994) also did not identify
age-related differences in women�s experiences of eating disorder symptomatology.
Subjects of this study were fifty elderly (aged 60-78 years according to this study) and
fifty young (aged 18-31 years according to this study) women. Eating disorder
symptomatology was measured using the Eating Attitudes Test (Garner & Garfinkel,
1979), and no significant age-related differences in level of eating disorder
symptomatology were identified.
2.4 Summary of age in relation to eating disorder and body image concerns
Clearly, the literature on the role of age in relation to eating disorder and body image
concerns has produced varied findings. It is important to note that this literature includes
many different constructs, measures and age groupings; therefore, it is somewhat
disjointed and in need of integration. With regard to the literature addressing age in
relation to body image concerns, some studies (e.g., Greenleaf, 2005; McKinley, 1999)
suggested that older women may experience lower levels of body surveillance and body
shame as measured by subscales of the OBC (McKinley & Hyde, 1996). In comparison
to younger women, older women have been found to endorse: larger ideal body shapes
(Deeks & McCabe, 2001); lower levels of appearance importance (Pliner, Chaiken, &
Flett, 1990); lower levels of self-objectification (Tiggemann & Lynch, 2001); and lower
levels of appearance anxiety (Tiggemann & Lynch, 2001). In contrast, another line of
research has failed to provide support for age-related differences in women�s body
20
image-related concerns such as: body dissatisfaction (Altabe & Thompson, 1993;
Tiggemann & Lynch, 2001; Webster & Tiggemann, 2003) as measured by three different
scales; body importance (Webster & Tiggemann, 2003); body shame as measured by the
OBC Body Shame subscale (McKinley & Hyde, 1996; Tiggemann & Lynch, 2001); and
body related attitudes (Ben-Tovim & Walker, 1994).
With regard to the literature addressing age in relation to eating disorders, a couple of
studies (Lewis & Cachelin, 2001; Tiggemann & Lynch, 2001) utilizing the EDI (Garner
et al., 1983) revealed that older women appeared to experience fewer symptoms of
disordered eating than younger women. In addition, a couple of studies (Rand & Kuldau,
1991; Tiggemann & Lynch, 2001) utilizing the Revised Restraint Scale (Herman &
Polivy, 1980) identified lower levels of dietary restraint in older women as compared to
younger women. Other studies (Hetherington & Burnett, 1994; Stokes & Frederick-
Recascino, 2003) have failed to find significant age-related differences in eating disorder
symptomatology measured by the EAT (Garner & Garfinkel, 1979). Again, extant
research on body image and eating behaviors is rife with disjointed findings including
various pathology-oriented constructs, diverse methodologies, and assorted age
groupings.
The present study offers incremental value to extant literature by specifically
examining body image and eating constructs with samples of women older than the
traditionally-aged, young undergraduate. There are several theoretically plausible
arguments regarding the importance of examining age effects associated with women's
body image and eating concerns. From a developmental perspective, it is conceivable
21
that a woman's body image may become poorer as she ages and increases her distance
from the youthful beauty ideal (Tiggemann & Lynch, 2001). As women age, they are
likely to gain approximately ten pounds per decade, experience a change in body fat
distribution, lose skin elasticity, and experience thinning and/or graying hair (Andres,
1989). Further, developmental milestones (e.g., puberty, pregnancy, menopause) in a
woman's lifespan may predispose her to increased body fat (Rodin et al., 1985).
Researchers have also written about the "double standard of aging" in which older
women are held to a higher standard of attractiveness as compared to the standard of
attractiveness to which older men are held (Wilcox, 1997, p. 549). Research also
suggests that older women are more concerned about the negative effects of aging on
their appearance as compared to older men, and researchers associate this finding with
the notion that attractiveness is central to women's identity (Gupta & Schork, 1993).
Certainly, these lines of research underscore plausible reasons to investigate body image
and eating constructs among women aged across the adult lifespan.
While a small number of studies (e.g., Greenleaf, 2005; Hill, 2003; Tiggemann &
Lynch, 2001) have specifically applied more integrative frameworks of disordered eating
with women of diverse ages, no present studies have investigated models or constructs of
positive eating behaviors and body image with women of diverse ages. Due to the lack
of integated and consistent findings regarding the impact of age on body image and
eating disorder concerns, it is unclear how constructs and a model of positive eating
behaviors may differentially apply to older and younger women. Therefore, a review of
extant literature exploring constructs and a model of positive eating behaviors and body
22
image (i.e., an acceptance model of intuitive eating) as applied with samples of
predominantly young, traditionally-aged undergraduates will be provided below.
2.5 A Model of Intuitive Eating
Again, while many scholars have proposed conceptual frameworks in an attempt
to further understanding of how certain variables meaningfully interact to predict eating
disorder symptomatology and body image disturbance (e.g., Fredrickson & Roberts,
1997; Hund & Espelage, 2005; Mazzeo & Espelage, 2002; Stice, Nemeroff, & Shaw,
1996; Tylka & Subich, 2004), a paucity of research exists to further knowledge of how
variables interact to predict adaptive eating behaviors and positive body image.
Fortunately, scholars (Avalos et al., 2005; Tylka, 2006) have begun to address this
paucity, as they have applied a strength-based approach to the study of eating behaviors
and body image.
Avalos and Tylka (2006), Tylka (2006), and Tylka and Wilcox (2006) offer forth
research on growth-oriented body image and eating concepts (i.e., general unconditional
acceptance, body acceptance by others, emphasis on body function, body appreciation,
intuitive eating), as well as a model framework (i.e., an acceptance model of intuitive
eating) in an attempt to understand the relationships among such constructs. Such
research is important, because it attempts to more clearly articulate whether adaptive
eating is merely the absence of eating disorder symptomatology or whether it contains
unique constructs not captured in a disordered eating continuum framework (Tylka &
Wilcox, 2006). Again, this approach to studying body image and eating behaviors by
exploring potential affirmative strengths (e.g., adaptive eating behaviors and attitudes)
23
rather than simply identifying the absence of pathological symptoms (e.g., dietary
restraint, preoccupation with food, binge eating) is consistent with tenets of counseling
psychology and positive psychology.
Avalos and Tylka (2006) adopted such an approach when they developed and
demonstrated empirical support for a model of a form of adaptive eating called intuitive
eating. In creating this acceptance model of intuitive eating, Avalos and Tylka (2006)
drew from theoretical writings about intuitive eating (i.e., Tribole & Resch, 1995), from
work conducted by Avalos et al. (2005) and Tylka (2006), from Rogers�s (1961) theory
of acceptance, and from the literature addressing predictors of eating disorder
symptomatology and body image disturbance. Intuitive eating is a form of adaptive
eating that has recently gained increased recognition. Intuitive eating is defined as a
strong connection with, understanding of, and eating in response to, internal
physiological hunger and satiety cues (Tribole & Resch, 1995). Tribole and Resch
(1995) identified three central and interrelated components of intuitive eating, which are:
(a) unconditional permission to eat what food is desired and when hungry, (b) eating for
physical rather than emotional reasons, and (c) reliance on internal hunger and satiety
cues to determine when and how much to eat (Tylka, 2006). Research by Tylka and
Wilcox (2006) aided the conceptualization of the construct of intuitive eating as unique
from low levels of eating disorder symptomatology, which provides justification for
exploring potential contributors to this construct.
Indeed, findings from Tylka and Wilcox (2006) suggested that intuitive eating and
eating disorder symptomatology are not merely opposite ends of the same construct, as
24
intuitive eating was found to predict variance in positive psychological well-being above
and beyond that accounted for by eating disorder symptomatology (Tylka & Wilcox,
2006). In other words, the presence of low levels of eating disorder symptomatology is
not synonymous with the presence of intuitive eating. Because some of the
aforementioned research suggested that older women may have different experiences
with body image, eating, and well-being as compared to younger women, the present
study is a useful attempt to investigate and compare the applicability of a model of
intuitive eating with older and younger women. Therefore, the constructs of the theory
and predictive model of intuitive eating proposed by Avalos and Tylka (2006) will be
discussed in more detail below within the context of any empirical support for pathways
proposed by the model.
2.51 General Unconditional Acceptance
In the model proposed by Avalos and Tylka (2006), the authors describe the
starting point of their framework as general unconditional acceptance. Figure 1
illustrates the pathways of the model proposed by Avalos and Tylka (2006). They
conceptualize general unconditional acceptance as the degree to which a woman
perceives that significant people in her life accept her internal self and external body
shape and weight (Avalos & Tylka, 2006). This conceptualization of general
unconditional acceptance is rooted in humanistic theory proposed by Rogers (1961),
which highlights perceived unconditional acceptance from (an) influential other(s) in
one�s life as the most important and often inadequate childhood experience.
25
Rogers (1961) theorized that, although humans are born with a proclivity towards
growth and self-actualization, a lack of perceived general unconditional acceptance and
other social influences can unfortunately deter an individual�s growth. Rogers (1961)
posited that when an individual perceives general unconditional acceptance from
significant others, that individual is then able to capitalize upon his/her actualizing
potential and inborn tendency to expand, extend, and develop in a growth-enhancing
manner. Conversely, if an individual does not perceive general unconditional acceptance
from significant others, his/her growth would be restricted as he/she experiences
difficulty aligning with and capitalizing upon his/her actualizing potential (Rogers, 1961).
Rogers (1964) also suggested that such incongruence as a result of a lack of perceived
general unconditional acceptance may lead an individual to attempt to attain unrealistic
societal ideals. It is theorized that when one does not perceive general unconditional
acceptance, one is prone to deny one�s inner experiences and instead adopt external rules
(Rogers, 1961).
Avalos and Tylka (2005) proposed that intuitive eating is one expression of the
actualizing tendency, as it is a reflection of honoring one�s inner experiences (i.e., hunger
and satiety cues) and valuing one�s bodily needs. Similarly, other researchers (Carper et
al., 2000; Tribole & Resch, 1995) have suggested that the tendency to eat intuitively is
innate, but that the likelihood of continuing this eating style is dependent upon an
accepting environment. Hence, if one perceives an environment of general acceptance,
one is more likely to honor one�s internal experiences and eat intuitively. Conversely, if
26
an environment of general acceptance is not perceived, one is more likely to deny one�s
inner experiences (i.e., hunger and satiety cues) and instead adopt societal rules (e.g.,
dieting) regarding eating behaviors.
Theory proposed by Fredrickson & Roberts (1997) described a potentially similar
process of adopting unrealistic societal ideals. Their theory of objectification theory
(Fredrickson & Roberts, 1997) detailed a process of self-objectification, or internalization
of the thin-ideal, which is characterized by habitual body monitoring and an emphasis on
body appearance (as opposed to body function). Avalos and Tylka (2006) proposed then,
that women who are less likely to perceive general unconditional acceptance may be
more likely to identify with societal ideals through internalizing such thin-ideal
stereotypes and habitually monitoring their body appearance (Fredrickson & Roberts,
1997). Figure 1 presents an illustration of this proposed pathway (Path b).
Keeping a focus on hygiology, Avalos and Tylka (2006) suggested that
conversely, those who perceive that they are unconditionally accepted by influential
others will not have a drive to abandon their real self and strive towards an ideal self;
these individuals then will be likely to focus on how their body functions and feels rather
than how it appears to others. Therefore, Avalos and Tylka (2006) proposed that
perceived acceptance from others (i.e., the most influential person in a woman�s life
when she was growing up) would predict her emphasis on body function. Additionally,
Avalos and Tylka (2006) hypothesized that when a woman perceives general
unconditional acceptance from her environment, then she will be likely to perceive that
others accept her body. Accordingly, Avalos and Tylka (2006) formulated the hypothesis
27
that perceptions of general unconditional acceptance could lead to women feeling that
their bodies are accepted by others (Path a in Figure 1). With a more pathological focus,
research has demonstrated that low levels of unconditional acceptance from friends and
family (i.e., low social support) have been associated with pressures to adopt the thin
ideal and lose weight among college women (Tylka & Subich, 2004).
Results by Avalos and Tylka (2006) provided empirical support for the pathway
from general unconditional acceptance to perceptions that others are accepting of one�s
body; however, empirical evidence was not garnered to support the pathway from
perceptions of general unconditional acceptance to an emphasis on body functionality
over body appearance. This finding was contrary to their hypothesis, and they suggested
that rather than general unconditional acceptance measured as perceived support from the
most influential person in a woman�s life when she was growing up, perhaps a different,
specific type of unconditional acceptance (i.e., perceived social support from their overall
network of family and friends) may be a more powerful predictor of an emphasis on body
function over appearance. Accordingly, the present study takes such suggestions into
consideration, conceptualizing general unconditional acceptance as perceived social
support.
This conceptualization of social support as a reflection of general unconditional
acceptance remains consistent with the theoretical underpinnings of the acceptance model
of intuitive eating. Scholars (Carper et al., 2000; Tribole & Resch, 1995) have suggested
that although the proclivity for intuitive eating is innate, the actualization of this behavior
depends on the level of acceptance perceived in the environment. It is conceivable that
28
women perceive social support as a manifestation of environmental acceptance. The
instrument used to measure social support in the present study incorporates multiple
provisions of social relationships, which could arguably be conceptualized as reflections
of acceptance by significant others in one's life. It seems that perceived social support
may suggest to a woman that others are accepting and supportive of who she is, which
appears to be consistent with the humanistic theory underlying the model of intuitive
eating examined in the present study (Avalos & Tylka, 2006; Rogers, 1964; Tribole &
Resch, 1995).
Additionally, prior research suggests that perceived social support is a mental-
health promoting factor, as it has been shown to predict positive self-appraisal (i.e., an
indicator of well-being), as well as global self-esteem. Research with more of a
pathological focus also lends credence to this conceptualization through findings that a
lack of perceived social support has been associated with an emphasis on body
appearance rather than body function (Fredrickson & Roberts, 1997). In sum, extant
literature seems to support the plausibility of conceptualizing social support as a
reflection of general unconditional acceptance.
2.52 Body Acceptance by Others
Avalos and Tylka (2006) reasoned that perceptions that others accept one�s body
may lead one to be less preoccupied with changing one�s body, perhaps allowing one to
instead focus on how one�s body feels and functions (Tribole & Resch, 1995).
Conversely, research has demonstrated that pressures by significant others to be thin
predicted an increase in women�s habitual body monitoring and a decrease in one�s
29
emphasis on body functionality (Tylka & Hill, 2004). Additionally, a study by Birch,
Johnson, Andresen, Petersen, and Schulte (1991) demonstrated that children�s perceived
pressure from caregivers to lose weight was significantly related in a positive direction to
the emergence of dietary restraint and weight gain among young girls. Further, such
pressure may also lead children to replace internal hunger and satiety cues with external
cues to dictate where, when, and how much to eat (Birch, Fisher, & Davison, 2003;
Carper, Fisher, & Birch, 2000). Therefore, Avalos and Tylka (2006) proposed that
perceived body acceptance by others would predict an emphasis on body function (Path c
in Figure 1). This pathway was empirically supported in their study (Avalos & Tylka,
2006).
Avalos and Tylka (2006) further proposed that perceived body acceptance by
others would also predict one�s positive feelings toward one�s body, demonstrated
through a construct such as body appreciation. Research by Tantleff-Dunn and Gokee
(2002) suggested that others� opinions have a profound effect on how one feels about
one�s body. Similarly, Fredrickson and Roberts (1997) proposed that body
dissatisfaction/shame occurs when one recognizes that one�s body falls short of the
cultural ideal. Accordingly, women who perceive body acceptance from others may not
be receiving messages to alter one�s bodies. Therefore, Avalos and Tylka (2006)
proposed that such women may be less likely to experience this discrepancy, and
therefore their body appreciation will not be negatively impacted. In a similar vein,
research (Stice et al., 1996; Tylka & Hill, 2004) suggested that perceived pressure for
thinness from a significant other and from the media predicted body dissatisfaction
30
among girls and women, above and beyond that accounted for by habitual body
monitoring. Therefore, Avalos and Tylka (2006) hypothesized that perceived body
acceptance by others would predict body appreciation in the model (Path d in Figure 1).
Findings supported this pathway in the model of intuitive eating (Avalos & Tylka, 2006).
Another hypothesis proposed by Avalos and Tylka (2006) is that both body
appreciation and body function would offer explanatory value for the relationship
between body acceptance by others and intuitive eating. This hypothesis was founded on
the proposition that the extent to which body acceptance by others influences whether
women engage in intuitive eating is dependent on their adoption of a positive body
orientation (Tribole & Resch, 1995). Similarly, research has found that a negative body
orientation accounts for the relationship between pressure for thinness and disordered
eating (Tylka & Hill, 2004; Tylka & Subich, 2004). Indeed, findings by Avalos and
Tylka (2006) provide empirical support for the pathway from emphasis on body function
to intuitive eating (Path e in Figure 1), as well as the pathway from body appreciation to
intuitive eating (Path g in Figure 1).
2.53 Body Function
Avalos and Tylka (2006) proposed that a focus on body function as opposed to
external bodily appearance may lead one to be more appreciative of one�s body.
Conversely, a focus on body appearance and associated habitual body monitoring (i.e.,
body surveillance) has been found to be negatively related to body appreciation (Avalos
et al., 2005). In a similar vein, body surveillance has been demonstrated to predict body
shame (Moradi et al., 2005; Tylka & Hill, 2004). Therefore, Avalos and Tylka (2006)
31
hypothesized, and found support for, the proposition that an emphasis on body function
would predict body appreciation (Path f in Figure 1).
Additionally, an emphasis on body function was hypothesized to predict intuitive
eating behaviors, with the rationale that an emphasis on function may encourage one to
eat with the purpose of aiding one�s body functioning, as well as according to one�s
internal hunger and satiety signals (Tribole & Resch, 1995; Tylka, 2006). Conversely,
research has shown that habitual body monitoring of appearance predicted disordered
eating among college women, even after accounting for the variance in disordered eating
explained by body shame (Moradi, Dirks, & Matteson, 2005). Accordingly, Avalos and
Tylka (2006) found support for the pathway from emphasis on body function to intuitive
eating (Path e in Figure 1).
2.54 Body Appreciation
A study conducted by Avalos et al. (2005) first introduced the variable of body
appreciation, as well as an instrument called Body Appreciation Scale (BAS) which was
designed to measure body appreciation. Avalos et al. (2005) proposed that body
appreciation is a component of positive body image. Indeed, Avalos et al. (2005)
conceptualize body appreciation as involving unconditional approval and respect of the
body. Further, body appreciation is characterized by the following four components: (a)
favorable evaluations of one�s body regardless of perceived congruence with the societal
ideal appearance, (b) body acceptance in spite of weight, body shape, and imperfections,
(c) respecting one�s body by attending to its needs and engaging in healthy behaviors,
and (d) protection of one�s body by rejecting unrealistic images of the thin-ideal
32
prototype portrayed in the media. Body appreciation was found to be positively
associated with adaptive personality characteristics (i.e., self-esteem, life satisfaction,
proactive coping and optimism) and negatively associated with body image disturbance
and disordered eating (Avalos et al., 2005).
The authors also underscored that notion that the majority of research on body image
and eating disorder concerns has been primarily pathology-focused (Avalos et al., 2005).
They also drew attention to studies (e.g., Striegel-Moore & Cachelin, 1999) in which
authors implored future psychologists to investigate predictors and outcomes of positive
body image. Striegel-Moore and Cachelin (1999) posited that while such predictors of
positive body image may be the reverse of predictors of negative body image (e.g.,
positive self-esteem as opposed to negative self-esteem), predictors of positive body
image may also be unique and distinct concepts from predictors of negative body image.
Building upon this research and recognizing that body image has been conceptualized
and assessed almost exclusively in terms of its negative characteristics, Avalos et al.
(2005) chose to extend existing literature by developing and evaluating their measure of
body appreciation.
The BAS was developed and evaluated via four independent samples of college
women (aged 17-55). In the first study, participants were 181 female college students
(Avalos et al., 2005). Results garnered from the administration of the BAS provided
evidence in support of unidimensionality and construct validity. In particular, scores on
the BAS were strongly positively associated with higher body esteem, perceptions of
sexual attractiveness, physical condition, and lower weight concern, lower body
33
surveillance, and lower body shame. These findings provide initial support for the BAS�s
convergent validity. Also as predicted, BAS scores were strongly related to self-esteem
and moderately-to-strongly related to optimism and proactive coping, supporting its
association with several indices of psychological well-being. Further, the study yielded
evidence of internal consistency reliability.
In the second study conducted by Avalos et al. (2005), participants were 327
undergraduate women (aged 17-30). This study provided evidence of cross-validation for
the unidimensionality of the BAS. The third study provided additional evidence for the
construct validity of the BAS, as scores were: (a) strongly associated in a positive
direction with a greater tendency to evaluate one�s appearance favorably (b) strongly
associated in a negative direction with body preoccupation, (c) strongly associated in a
negative direction with body dissatisfaction and (d) strongly related in a negative
direction to eating disorder symptomatology. Additionally, a significant relation between
scores on the BAS and scores on a scale of impression management was not supported.
An additional finding of interest was that the BAS predicted unique variance in
psychological well-being above and beyond extant measures of body image.
In the fourth study, which involved 177 female college undergraduates (aged 17-20),
demonstrated adequate temporal stability over a 3-week period. The authors concluded
that the BAS should prove useful for researchers and clinicians interested in positive
body image assessment. Accordingly, the BAS will be incorporated into the present
study.
34
Researchers (Avalos et al., 2005; Tribole & Resch, 1995) have asserted that
women who respect and appreciate their bodies may be more aware of their bodily needs,
including their internal hunger and satiety cues. Therefore, such individuals who
appreciate their bodies may also be more likely to respect their hunger and satiety cues
when eating. Research has clearly demonstrated that women who do not demonstrate
body appreciation (i.e., have high levels of body dissatisfaction/ shame) tend to have
higher levels of disordered eating (e.g., Moradi et al., 2005; Stice et al., 1996; Tylka &
Hill, 2004; Tylka & Subich, 2004). Hence, body appreciation was proposed to predict
intuitive eating, and support for this pathway was ascertained (Avalos & Tylka, 2006).
2.55 Intuitive Eating
Intuitive eating is defined as a strong connection with, understanding of, and
eating in response to, internal physiological hunger and satiety cues coupled with low
preoccupation with food (Hawks, Merrill, & Madanat, 2004; Tribole & Resch, 1995;
Tylka, 2006). Scholars posit that intuitive eating is comprised of three central and
interrelated components of intuitive eating: unconditional permission to eat when hungry
and what food is desired, eating for physical rather than emotional reasons, and reliance
on internal hunger and satiety cues to determine timing and amount of food to consume
(Tribole & Resch, 1995; Tylka, 2006). Unconditional permission to eat is described as
occurring when a woman does not ignore her hunger signals or classify food according to
acceptable and non-acceptable categories (Faith, Scanlon, Birch, Francis, & Sherry,
2004; Polivy & Herman, 1999). Eating for physical rather than emotional reasons entails
eating in an attempt to satisfy a physical hunger drive, as opposed to using eating
35
behaviors in an attempt to cope with emotional fluctuations and/or distress (Tribole &
Resch, 1995). Reliance on internal hunger and satiety cues involves women being both
aware and trusting of these signals to guide their eating behavior (Carper et al., 2000;
Tribole & Resch, 1995).
Research has supported the positive aspects and notion of intuitive eating as an
adaptive behavior. For example, intuitive eating has been shown to be positively
associated with many adaptive personality characteristics (e.g., self-esteem, life
satisfaction, proactive coping, and optimism) and negatively associated with body image
disturbance and disordered eating among college women (Tylka, 2006). Again, as
mentioned previously, intuitive eating and eating disorder symptomatology do not seem
to be merely opposite ends of the same construct, as intuitive eating was found to predict
variance in positive psychological well-being above and beyond that accounted for by
eating disorder symptomatology (Tylka & Wilcox, 2006). Further research with the
construct of intuitive eating would certainly be desirable.
2.6 Summary
Figure 1 presents a conceptual framework integrating contextual and intrapersonal
variables hypothesized to predict body appreciation and intuitive eating. This model was
originally proposed by Avalos and Tylka (2006) and provided an adequate overall fit to
the data for two samples of undergraduate women; however, this model has yet to be
tested with samples other than convenience samples of mostly young (i.e., aged 18-22)
women. It is hoped that a framework such as the model proposed by Avalos and Tylka
36
(2006) may further elucidate how certain variables interact meaningfully to contribute to
a positive body orientation and adaptive intuitive eating behaviors in women of diverse
ages.
Accordingly, the purpose of the present study is to test a model of intuitive eating
with one group of women aged 18-24 years and with a second group of women aged 25-
79 years. In particular, the present study will use the method of latent variable SEM to
determine whether the specified pathways of a model of intuitive eating apply to a sample
of older women (i.e., 25-79 years old) as well as to a comparison sample of younger
women (i.e., 18-24 years old) of a more traditional undergraduate age. These age
divisions have been used frequently within the literature to delineate the age ranges of
traditional versus nontraditional undergraduates (e.g., Bean & Metzner, 1985; Butler,
1998; Chartrand, 1992; Hirschorn, 1988; Metzner & Bean, 1987). The present study
attempts to integrate, apply, and extend existing literature on women�s eating and body
image concerns by exploring a model of intuitive eating with women of diverse ages. As
previous research has not applied pathways of a model of intuitive eating with women
older than the traditional undergraduate, it is therefore unknown whether the pathways
proposed by such a model will extend beyond women aged 18-24 years old.
2.7 Purpose of the Study
The purpose of the present study is to conduct an examination of the fit of the
model presented in Figure 1 and to evaluate whether its hypothesized pathways are
upheld with a sample of women aged 25-79, as well as with a sample of women aged 18-
24. The present study will add incrementally to the general body of literature addressing
37
eating and body image concerns by providing further empirical investigation regarding
the concept of intuitive eating. Additionally, this study constitutes an attempt to further
elucidate a conceptual framework for understanding the interaction of eating-related
constructs for women of diverse ages.
2.8 Hypotheses of Study
The present study seeks to test the applicability of a model of intuitive eating (see
Figure 1) as applied to groups of younger (i.e., 18-24) and older (i.e., 25-79) women.
Accordingly, the following hypotheses will be tested with a group of women aged 18-24
years and with a group of women aged 25-79 years:
Hypothesis 1: Perceptions of general unconditional acceptance will predict
perceptions of body acceptance by others.
Hypothesis 2: Perceptions of general unconditional acceptance will predict
emphasis on body function (rather than body appearance).
Hypothesis 3: Perceptions of body acceptance by others will predict emphasis on
body function (rather than body appearance).
Hypothesis 4: Perceptions of body acceptance by others will predict body
appreciation.
Hypothesis 5: Emphasis on body function (rather than body appearance) will
predict body appreciation.
38
Hypothesis 6: Emphasis on body function (rather than body appearance) will
predict intuitive eating.
Hypothesis 7: Body appreciation will predict intuitive eating
If the model implied by these aforementioned hypotheses is not upheld for an age
group(s), a preliminary model will be proposed as needed for the age group(s).
39
CHAPTER 3
METHOD
3.1 Participants
A total sample size of 688 women, ranging in age from 18 to 79 years (M = 31.55,
SD = 13.95), was obtained using Internet data collection and analyzed. Five hundred
seventy-nine women (84.2%) identified as Caucasian/Euro American, 39 women (5.7%)
identified as African American, 16 (2.3%) women identified as Latina/Hispanic, 25
(3.6%) women identified as Asian American, 6 (0.9%) women identified as Native
American, 7 women (1.0%) identified as International, 5 (0.7%) identified as biracial,
and 6 women (0.9%) identified as multiracial. Five women (0.7%) chose not to reply to
this item.
In classifying their socioeconomic status, 65 (9.4%) participants identified as
upper class, 547 (79.5%) participants identified as middle class, 69 (10.0%) participants
identified as working class/lower class, and 7 (1.0%) participants did not reply to this
item. Most women (33.4%) were married, while 30.7% were single, 23.0% were in a
long-term relationship, 3.5% were divorced or separated, 4.8% were partnered, 0.9% was
widowed, and 0.4% did not reply to the question.
40
In terms of highest education level attained, most women (40.8%) had some
college education, while 33.0% completed graduate or professional school, 10.0%
completed college, 7.1% had some graduate school, 7.6% completed high school, 1.3%
did not reply, and 0.1% completed some high school. In terms of participants� identified
college rank, 26.6% were first-year students, 7.3% were second-year students, 5.4% were
third-year students, 4.8% were fourth-year students, 2.0% were fifth-year students, and
2.6% were continuing education students. Most (47.7%) participants reported engaging
in approximately 30 minutes of exercise 2-4 days per week, 37.6% reported engaging in
such exercise 1 or less days per week, and 14.7% reported 5-7 days per week.
For the overall sample, reported weights and heights of participants resulted in a
range of body mass indices from 16.1 to 54.8, with a mean BMI of 25.64, which is
categorized into the overweight weight range (BMI = 25-30) as defined by Garrow and
Webster (1985). Following guidelines for weight ranges defined by Garrow and Webster
(1985), most women (55.2 %) fell within the normal weight range (BMI = 18.5-24.9),
followed by 21.5 % classified as overweight (BMI = 25-29.9), 20.2% classified as obese
(BMI ≥30), and 3.1% classified as underweight (BMI < 18.5).
For the purposes of this study (i.e., to explore a model of intuitive eating applied
to women of traditional undergraduate age and to women older than the traditional
undergraduate age), the overall sample was divided into two age groups. These age
groups were established based on classifications used by many organizations and
different scholars (e.g., Bean & Metzner, 1985; Butler, 1998; Chartrand, 1992; Hirschorn,
41
1988; Metzner & Bean, 1987) to differentiate traditionally-aged undergraduates from
nontraditionally-aged undergraduates. The next sections discuss the demographics of
both subgroups of women.
3.11 Women aged 18 to 24 years old
The younger group of women of traditional undergraduate age was comprised of
307 women, ranging in age from 18 to 24 years (M = 19.28, SD = 1.61). Two hundred
forty-six women (80.1%) identified as Caucasian/Euro American, 21 women (6.8%)
identified as African American, 9 (2.9%) women identified as Latina/Hispanic, 19 (6.2%)
women identified as Asian American, 1 (0.3%) women identified as Native American, 2
(0.7%) identified as International, 3 women (1.0%) identified as biracial, and 3 women
(1.0%) identified as multiracial. Three (1.0%) women chose not to reply to this item.
In classifying their socioeconomic status, 23 (7.5%) participants identified as
upper class, 243 (79.2%) participants identified as middle class, 37 (12.1%) participants
identified as lower/working class, and 4 (1.3%) participants did not reply to this item.
Most women (50.5%) were single, while 39.1% were in a long-term relationship, 2.6%
were partnered, 1.0% was married, 0.3% was divorced, and 6.6% did not reply to the
question.
In terms of highest education level attained, most women (76.5%) had some
college education, whereas 16.0% completed high school, 3.9% completed college, and
2.6% completed some graduate school, and 1.0% did not reply. For those women
indicating college rank, if applicable, 58.0% were first-year students, 15.3% were second-
year students, 9.8% were third-year students, 8.1% were fourth-year students, 3.3% were
42
fifth-year students, 0.3% was a continuing education student, and 5.2% did not reply.
Most (46.3%) participants reported engaging in approximately 30 minutes of exercise 2-4
days per week, 39.7% reported engaging in such exercise 1 or less days per week, and
14.0% reported 5-7 days per week.
For women aged 18-24, reported weights and heights of participants resulted in a
range of body mass indices from 16.10 to 54.8, with a mean BMI of 23.79, which is
categorized into the normal weight range (BMI = 20-24.9) as defined by Garrow and
Webster (1985). Following guidelines for weight ranges defined by Garrow and Webster
(1985), most women (67.1 %) fell within the normal weight range (BMI = 18.5-24.9),
followed by 16 % classified as overweight (BMI = 25-29.9), 10.7% classified as obese
(BMI ≥30), and 6.2% classified as underweight (BMI < 18.5).
3.12 Women aged 25 to 79 years old
The second age group of older women was comprised of 381 women, ranging in
age from 25 to 79 years (M = 41.43, SD = 11.39). Of this age group, 333 women
(87.4%) identified as Caucasian/Euro American, while 6 women (1.6%) identified as
Asian American. Further, 7 (1.8%) women identified as Latina/Hispanic, while 3 (0.8%)
women identified as multiracial, 2 (0.5%) identified as biracial, 5 (1.3%) women
identified as Native American, 5 (1.3%) women identified as International, and 18 (4.7%)
women identified as African American. Two (0.5%) women chose not to reply to this
item.
In classifying their socioeconomic status, 42 (11.0%) participants identified as
upper class, 304 (79.8%) participants identified as middle class, 32 (8.4%) participants
43
identified as working/lower class, and 3 (0.8%) participants did not reply to this item.
Most women (59.6%) were married; however, 10.0% were in a long-term relationship,
14.7% were single, 6.6% were partnered, and 6.0% were divorced or separated, 1.6%
were widowed, and 1.6% did not reply to the question.
In terms of highest education level obtained, most women (59.6%) had completed
graduate school, followed by 15.0% who had completed college, 23.7% who had
completed some graduate school, and 12.1% who had some college education, 10.8%
completed some graduate school, 0.8% who had completed high school, and 0.3% who
had completed some high school. Six women (1.6%) did not reply. Of the women
indicating that they were in college, 1.3% were first-year students, 0.8% were second-
year students, 1.8% were third-year students, and 2.1% were fourth-year students, and
1.0% fifth-year students, and 4.5% were continuing education students. Most (48.8%)
participants reported engaging in approximately 30 minutes of exercise 2-4 days per
week, followed by 36.0% who reported engaging in such exercise 1 or less days per
week, and 15.2% who reported 5-7 days per week.
Reported weights and heights of participants aged 25-79 resulted in a range of
body mass indices from 17.8 to 54.8, with a mean BMI of 27.1 which is categorized into
the overweight weight range (BMI = 25-30) as defined by Garrow and Webster (1985).
Following guidelines for weight ranges defined by Garrow and Webster (1985), most
women (45.2 %) fell within the normal weight range (BMI = 18.5-24.9), followed by
27.3% classified as obese (BMI ≥30), 26% classified as overweight (BMI = 25-29.9), and
1.0% classified as underweight (BMI < 18.5).
44
3.2 Procedure
Participants in both groups were recruited via introductory psychology classes at a
large Midwestern university and electronic mail and listservs, relying on snowball
sampling methods. Electronic mail messages were sent to students of these classes and
nationwide to friends, family, colleagues, professors, professional listservs (e.g., The
Women�s Place, The Women�s Fund of Central Ohio), and campus organizations (e.g.,
multicultural centers, GLBT student services, Women in Engineering, student affairs).
Efforts were made to recruit more diverse samples by targeting organizations and
listservs comprised of historically underrepresented and/or marginalized populations. The
emailed messages contained a brief description of the study, a request for participation
especially from �women aged 30 and older,� and an entreaty for the recipient to forward
the message to other women (see Appendix B). The electronic mail message also
provided a direct link with the URL address of the survey. Interested participants were
directed to a webpage that provided details regarding informed consent, efforts taken to
ensure anonymity, and reassurance that participants could exit their web browsers and
withdraw from participation at any time (see Appendix A). After indicating their consent,
they were immediately redirected to the survey webpage, where the measures and a
demographic information form (see Appendix H) were hosted. Two different survey
forms (containing opposite sequences of the measures) were administered in an attempt
to offset possible ordering effects. Women enrolled in introductory psychology classes at
the authors� university were given course credit for their participation.
45
No identifying information was collected from participants. Participants were
informed that although all standard precautions were taken, the complete security of the
data could not be guaranteed since the transmission of survey data via the Internet is not
completely secure. Additionally, the last webpage of the survey listed contact
information for various psychological services, as well as a statement urging participants
to use such information in the event that they felt distressed. Finally, upon completion of
the survey, participants were redirected to a website containing information on body
image and eating disorder concerns.
Several strategies were employed in an attempt to reduce the likelihood of
erroneous data. In accordance with suggestions by Schmidt (1997), date and time of
submission were screened in an attempt to decrease the likelihood of duplicate surveys.
Per recommendations by Dillon and Worthington (2003), three validity check questions
were integrated within the survey. These questions asked participants to choose certain
responses (e.g., �Please choose Strongly Agree for this item�) to control for
inattentiveness and random or careless responding. Participants who failed the validity
checks were not included in the data set. Also, ninety-eight women had a significant
amount of missing data (i.e., 15% or more of data points missing from at least one
measure) and were not included into the data set. Scores on measures were checked for
normal distribution, which indicated that the results were not detrimentally affected by
selection bias.
46
3.3 Measures
3.31 Perceived social support
The 24-item Social Provisions Scale (SPS; Cutrona & Russell, 1987, 1990; see
Appendix C) was used to measure women�s perceived general unconditional regard as
conceptualized as perceived social support. The instructions ask each participant to think
about her relationships with friends, family members, co-workers, community members,
and so on in answering items. An example of an item is �I have close relationships that
provide me with a sense of emotional security and well-being,� and responses are scored
on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). The SPS
offers six subscales, comprised of four items each: (a) Attachment, or feelings of safety
and security in a close emotional bond, (b) Social Integration, or having one�s interests
and concerns shared by others, (c) Reassurance of Worth, or having one�s skills and
abilities acknowledged, (d) Reliable Alliance, or assurance that one can count on
assistance being available if needed, (e) Guidance, or the availability of confidants or
authoritative others to provide advice; and (f) Opportunity for Nurturance, or the sense of
contributing to the well-being of another person.
Total scores were averaged to reflect overall perceived social support, with higher
scores reflecting greater perceived social support from influential others. Research has
provided evidence of internal consistency reliability for the total social support score, as
Alpha coefficient estimates have ranged from .82-.92 across a wide variety of samples
including post-partum women, spouses of cancer patients, the elderly, individuals
working in stressful job situations, and college undergraduates (see Cutrona & Russell,
47
1987). Research with this scale has also produced evidence of internal consistency
reliability for the subscale scores, ranging from α = .76 to α =.84 (Cutrona & Russell,
1987, 1990). In addition, Cutrona & Russell (1987, 1990) reported psychometric
evidence from a confirmatory factor analysis of a six factor structure corresponding to the
six social provisions of the scale (i.e., GFI =.86).
Further, total social support scores from the SPS were found to predict 66% of the
variance in scores on a measure of loneliness as completed by first-year undergraduate
students (Russell & Cutrona, 1984). With a sample of elderly participants in which the
average age was 70 years (range = 60-88 years), total scores on the SPS were
significantly negatively correlated with scores on a measure of depression, but positively
correlated with scores on a measure of life satisfaction (Cutrona, Russell, & Rose, 1986).
Research with samples of nurses and public school teachers has also revealed evidence of
validity through similar significant negative correlations between SPS total scores and
scores on a measure of depression, as well as similar significant positive correlations
between SPS total scores and scores on a measure of life satisfaction (Russell & Cutrona,
1984). Finally, evidence of discriminant validity has been gathered for the SPS from
research in which it was not significantly correlated with scores on a measure of
neuroticism, with scores on a measure of introversion-extroversion, or scores on a
measure of social desirability in a sample of college students (Cutrona & Russell, 1987).
Research investigating test-retest reliability over a period of two weeks has produced an
estimate of r = .66 in a sample of elderly community residents (Cutrona, Russell, & Rose,
1986).
48
3.32 Body acceptance by others
The Body Acceptance by Others Scale (BAOS; Tylka et al., 2006; see Appendix
E) was designed to assess specific forms of environmental acceptance regarding body
shape/weight. The BAOS contains a total of 10 items assessing perceived support and
acceptance for one�s body shape/weight. Sample items include �I�ve felt acceptance
from _______ regarding my body shape and/or weight� and �_______ have/has sent me
the message that my body shape and weight are fine.� Participants were asked to
complete items by first filling in the blank with specified sources of environmental
acceptance (i.e., friends, family, people they have dated, interactions with society, and
media). Then, for each item, participants ranked the perceived body acceptance from the
specified source. Specifically, the two aforementioned sample items were presented five
times, once for each environmental source to be evaluated. Items were rated on a 5-point
scale ranging from 1 (never) to 5 (always), and item scores were averaged to arrive at a
total score, with higher scores indicating greater perceived acceptance of body
shape/weight. Avalos and Tylka (2006) conducted a pilot study of this measure with a
sample of 66 college women (M age = 22.03, SD age = 5.67; 78.8% European
American), which garnered evidence of internal consistency reliability (α = .91) and
stability over a 3-week period (r = .85). Further evidence was yielded by Avalos and
Tylka (2006), with a reported alpha of .90.
3.33 Body function
Body function was assessed by the Body Surveillance subscale of the Objectified
Body Consciousness Scale (OBC; McKinley & Hyde, 1996; see Appendix D). The
49
subscale consists of eight items, which are rated on a scale ranging from 1 (strongly
disagree) to 7 (strongly agree). While this subscale was designed to assess the degree to
which one thinks of one�s body in terms of appearance rather than function, it is notable
that six items are framed in the direction of body function (e.g., �I think more about how
my body feels than how my body looks�). In the original scoring procedure, these six
items are reverse scored and added to the two items that are framed in the direction of
body surveillance (e.g., �During the day, I think about how I look many times�) to
determine women�s levels of body surveillance (McKinley & Hyde, 1996). However, in
the present study, these six items framed in the direction of body function were not
reverse scored; rather, the two items framed in the direction of body surveillance were
reverse scored.
Therefore, all items were scored in the direction of body function and then
averaged to form a total score, with higher scores reflecting greater emphasis on body
function over body surveillance/appearance. Scores on this subscale have been found to
yield evidence of internal consistency reliability (α = .89), stability over a 2-week period
(r = .79), and construct validity, as demonstrated by its relationship to public self-
consciousness (r = .73) in samples of mostly-traditionally-aged female undergraduates
(McKinley & Hyde, 1996). In addition, McKinley (1999) reported an internal
consistency reliability alpha of .76 for her sample of middle-aged women. Finally,
Avalos and Tylka (2006) reported an internal consistency reliability alpha coefficient
estimate of .86 for their sample of college women in which items were scored in the
direction of body function.
50
3.34 Body appreciation
The 13-item Body Appreciation Scale (BAS; Avalos et al., 2005; see Appendix F)
was used to measure the construct of body appreciation. A sample item is �Despite its
flaws, I accept my body for what it is,�), and items were rated on a 5-point scale ranging
from 1 (never) to 5 (always). Responses were then averaged, with higher scores
reflecting greater body appreciation. Research has provided support for the BAS�s
unidimensional factor structure, its internal consistency reliability (α estimates ranging
from .91 to .94), and its stability over a 3-week period (r = .90) in samples of college
women (Avalos et al., 2005). With regard to evidence of construct validity, scores on the
BAS were significantly positively correlated with scores on a measure of positive
appearance evaluation (r = .68), significantly negatively correlated with scores on a
measure of body preoccupation (r = -.79), significantly negatively correlated with scores
on a measure of body dissatisfaction (r = -.73), significantly positively related to scores
on a measure of self-esteem (r = .65) and negligibly correlated with scores on a measure
of impression management (r = .14) with college women (Avalos et al., 2005).
3.35 Intuitive eating
The construct of intuitive eating was measured using the Intuitive Eating Scale
(IES; Tylka, 2006; see Appendix G). The IES contains 21 items designed to assess the
three components of intuitive eating identified within the literature. The three
components are: unconditional permission to eat (e.g., �If I am craving a certain food, I
allow myself to have it�), eating for physical rather than emotional reasons (e.g., �I stop
51
eating when I feel full [not overstuffed]�), and reliance on internal hunger and satiety
cues (e.g., �I trust my body to tell me how much to eat�). Each item was rated on a 5-
point scale, ranging from 1 (strongly disagree) to 5 (strongly agree).
For the IES total score, research has supported its internal consistency reliability
(α estimates ranging from .85 to .89), its stability over a 3-week period (r = .90), and its
construct validity through its significant negative correlation with eating disorder
symptomatology (r = -.69) and poor interoceptive awareness (r = -.49) and through its
negligible relation with impression management (r = .12) in samples of college women
(Tylka, 2006).
3.4 Design
3.41 Latent Variable Structural Equation Modeling
The method of latent variable structural equation modeling (SEM) was used to
evaluate the acceptance model of intuitive eating and its pathways, as SEM provides a
more stringent evaluation of a model than path analysis. Latent variable SEM uses
multiple indicators to estimate a latent factor and can therefore attempt to control for
measurement error within the model (Kelloway, 1998). Mplus version 4.1 (Muthén &
Muthén, 2006) with ML estimation and covariance matrix as input was used to test the
model using multiple group analysis to test model invariance. Prior to evaluating the
structural model presented in Figure 1, the measurement model was tested for an
acceptable fit to the data through a confirmatory factor analysis, with parcels serving as
indicators for their respective latent variable. Results provided evidence as to the fit of
the model to the data by relying on consensus among indices: the χ2/df test, the
52
comparative fit index (CFI), the Tucker-Lewis index (TLI), the standardized root-mean-
square residual (SRMR), and the root-mean-square error of approximation (RMSEA)
(but note that the goodness-of-fit index [GFI] and the adjusted goodness-of-fit index
[AGFI] are not computed as part of the Mplus program). Specifically, models with CFI
and TLI values at or above .95 and SRMR and RMSEA values at or below .05 indicate
an excellent fit to the data, whereas models with CFI and TLI values between .90 and .94
and SRMR and RMSEA values between .06 and .10 indicate an adequate fit to the data
(Browne & Cudeck, 1993; Hu & Bentler, 1999). Values outside of these ranges reflect a
poor fit of the model to the data. If all parcels load significantly (p <.001) on their
respective latent factor, this will indicate that all latent factors were adequately
operationalized. Therefore, that measurement model would be used when testing the
structural model using multiple group analysis to test model invariance.
3.411 Creation of Measured/Observed Variables
The recommendations of Russell, Kahn, Spoth, and Altmaier (1998) were
followed in order to construct three measured indicators (parcels) for each latent variable
(i.e., general unconditional acceptance, body acceptance by others, body function, body
appreciation, and intuitive eating). First, for each measure, an exploratory factor analysis
was conducted using the ML method of extraction, specifying a single factor to be
extracted. Second, items were rank ordered according to the magnitude of the factor
loadings. Third, items were successively assigned (from the highest to the lowest factor
loading) to each of three parcels in order to equalize the average loadings of each parcel
on its respective latent factor. Finally, for each parcel, items were averaged to arrive at a
53
total score. Parcels were then used to estimate their respective latent variable within the
SEM analyses. For measures containing subscales, the procedure discussed above was
used in lieu of using the individual subscales to estimate the respective latent variable,
because using subscales has been shown to negatively impact the measurement and
structural model by producing lower factor loadings than parcels.
3.412 Multiple Group Analysis and Test of Model Invariance
Once it was determined that all parcels loaded significantly (p <.001) on their
respective latent factor and were adequately operationalized, the measurement model was
used to test the structural model and model invariance using multiple group analysis.
Specifically, a latent variable SEM multiple group analysis with test of model invariance
was run in order to determine whether the factor structure identified in the structural
model of Figure 1 would fit data from the older and younger groups equally well. Such
an analysis not only provides fit indices and path coefficients for the structural model as
applied to the two age groups, but it also compares the fit of the structural model across
the two age groups in order to provide evidence as to whether the seven structural
pathways illustrated in Figure 1 differed significantly between older and younger
participants in the present study.
A test of model invariance requires that two multiple group analyses be
conducted. In the first, less-restrictive multiple group analysis, the structural paths are
not fixed to be equivalent (i.e., the values of the structural paths are allowed to vary,
potentially suggesting different structural paths for the two groups). In the second, more
restrictive multiple group analysis, the structural paths are constrained to be invariant
54
(i.e., the values of the structural paths are fixed to be equal for both groups). During both
analyses, factor loadings are held invariant between the two groups so that constructs
would be measured similarly for the older and younger groups. If the difference in fit
between the less-restrictive and the more restrictive models is determined to be
significant, evidence exists to indicate inequality of the factor structure across the two
groups (i.e., that the structural coefficients do indeed differ between older and younger
women; Kahn, 2006; Liao, Rounds, & Klein, 2005; Long, 1998; Nauta, Epperson &
Kahn, 1998).
55
CHAPTER 4
RESULTS
4.1 Descriptive Statistics
Forty participants had a significant amount of missing data, and their responses
were not entered into the data set. These participants had 15% or more of the data points
missing from at least one measure. Twenty-seven participants failed more than one of
the validity checks; thus, their responses were not entered into the data set. Thirty-one
participants did not provide sufficient data to derive a BMI estimation; therefore, their
responses were not entered into the data set, either. For the 688 participants in the final
data set, missing data points were handled by substituting participants� mean scale or
subscale scores for the missing value. The final sample sizes of women aged 18-24 (n =
307) and women aged 25-79 (n = 381) exceeded the conservative cases-to-parameter
ratio of 10:1 for estimating the model using path analysis, as suggested by Hu and Bentler
(1995).
Measure scores were examined for evidence of skewness and kurtosis by visually
inspecting frequency histograms with a super-imposed normal distribution, as well as by
examining skewness and kurtosis statistic values produced from the data (Tabachnick &
Fidell, 1996). It was determined (per Tabachnick & Fidell, 1996) that no substantial
56
violations existed to jeopardize the assumptions of the analyses. The data was also
screened for outliers by using graphical methods applied to histograms as recommended
by Tabachnick and Fidell (1996). Because no outliers were identified, all 688 cases were
analyzed.
Scale means, standard deviations, alpha levels, and intercorrelations were
examined and are presented in Table 1 for the women aged 18-24 and Table 2 for the
women aged 25-79. Table 3 presents scale means, standard deviations, alpha levels, and
intercorrelations for all participants. Partial correlations (i.e., with body mass index
controlled) among measures are presented in Table 4 for younger women, Table 5 for
older women, and Table 6 for all women of the study. Consistent with past findings (e.g.,
Avalos & Tylka, 2006) the total scores for measures of social support, body acceptance
by others, body function, body appreciation, and intuitive eating were mostly moderately-
to-strongly positively correlated within both age groups, as well as within the total
sample (Cohen, 1992). Further, the variables were not highly correlated (i.e., r>.90;
Tabachnick & Fidel, 1996), providing support for the distinctiveness of each variable and
lending credibility to the latent variable SEM analyses.
A multivariate analysis of variance (MANOVA) was conducted with age group
placement (18-24 years, 25-79 years) as the independent variable and total scores of the
measures and BMI as the dependent variables in order to determine whether BMI and/or
measure scores of perceived social support, body acceptance by others, body function,
body appreciation, and intuitive eating differed with regard to age group placement. Age
group placement could be differentiated in terms of BMI and measure scores of perceived
57
social support, body acceptance by others, body function, and intuitive eating, F(6, 681)=
19.46, p< .001, Wilks�s Λ= .85). Results of univariate tests revealed that age group
placement had statistically significant (p < .05) unique effects on BMI, F(6, 681)= 42.88,
as well as on measure scores for perceived social support, F(1, 686)= 18.68; body
acceptance by others, F(1, 686) = 29.82; body function, F(1, 686) = 7.10; and intuitive
eating, F(1, 686) = 4.13. The only variable for which a significant univariate effect was
not found was that of body appreciation, F(1, 686) = 2.18, p > .05.
Further examination attempted to identify how BMI and measure scores behaved
across age groups. In terms of BMI, women aged 25-79 reported significantly higher
scores as compared to women aged 18-24 (p<.05). In terms of mean scores for perceived
social support, the older group of women aged 25-79 evidenced significantly higher
scores as compared to those evidenced by the younger women aged 18-24 (p<.05). With
regard to mean scores of body function, the older group of women aged 25-79 again
differed by evidencing a higher mean as compared to the younger group of women
(p<.05). In terms of mean scores of body acceptance by others, the younger group of
women aged 18-24 reported significantly higher scores as compared to the older group of
women aged 25-79 (p< .05). Finally, the mean scores of intuitive eating for the younger
group of women were also significantly higher than that of the older group of women (p<
.05).
4.2 Latent Variable SEM
Latent variable SEM, which uses multiple indicators to estimate a latent factor
and therefore attempts to control for measurement error (Kelloway, 1998), was used to
58
evaluate the measurement model (i.e., parcel-factor loadings and relationships among
latent variables) and the hypothesized structural model (i.e., including the hypothesized
paths between the latent variables, as presented in Figure 1). Mplus version 4.1 (Muthén
& Muthén, 2006) with ML estimation (using the covariance matrix as input) was used to
test these models. Adequacy of model fit to the data was determined by four indices
recommended by Hu and Bentler (1999) and provided by the Mplus program: χ2/df, the
comparative fit index (CFI), the Tucker-Lewis Index (TLI), the standardized root-mean
square residual (SRMR), and the root-mean square error of approximation (RMSEA).
Again, models with CFI and TLI values at or above .95 and SRMR and RMSEA values
at or below .05 indicate an excellent fit to the data, whereas models with CFI and TLI
values between .90 and .94, SRMR and RMSEA values between .06 and .10 indicate an
adequate fit to the data (Browne & Cudeck, 1993; Hu & Bentler, 1999). A χ2/df estimate
below 3.0 may be considered adequate or ideal (Browne & Cudeck, 1993; Hu & Bentler,
1999). Values outside of these ranges reflect a poor fit of the model to the data.
The measurement model was first examined through a confirmatory factor
analysis, with parcels serving as indicators for their respective latent variable. All parcels
loaded significantly (p <.001) on their respective latent factor, indicating that all latent
factors were adequately operationalized. Means, standard deviations, and partial
correlations among the fifteen observed measure parcels are presented in Table 7 for
women aged 18-24 and in Table 8 for women aged 25-79. For the younger group of
women aged 18-24, results indicated that the measurement model provided an adequate
(RMSEA=.07) to excellent (χ2/df = 2.65, CFI= .97, TLI=.96, SRMR=.05) fit to the data.
59
For the older group of women aged 25-79, results indicated that the measurement model
also provided an adequate (RMSEA=.06) to excellent (χ2/df = 2.20, CFI= .98, TLI=.98,
SRMR=.04) fit to the data. Once again, significant parcel-factor loadings (p <.001)
indicated that all latent factors were adequately operationalized. When the measurement
model was analyzed with both groups combined into one dataset, results indicated that
the measurement model provided an overall acceptable fit to the data (χ2/df = 8.24,
RMSEA=.10, CFI= .93, TLI=.91, SRMR=.05); although, consensus among fit indices
was not as clear in the combined dataset as compared to the separated younger and older
datasets. The χ2/df and RMSEA fit indices were higher than the standard cut off values
suggested by Hu and Bentler (1995) to indicate adequate fit. However, all parcels did
load significantly (p< .01) on their respective latent factors for the dataset combined to
include both age groups, indicating that all latent factors had been adequately
operationalized.
On the basis of the measurement model, parcel loadings and standard errors are
presented for the younger group of women aged 18-24 in Figure 2 and for the older group
of women aged 25-79 in Figure 3. The relationships among latent variables based on the
measurement model are presented in Table 9 for the younger group and in Table 10 for
the older group. Because results indicated an acceptable fit to the data and adequate
operationalization of latent factors for both age groups, the measurement model was used
to run a multiple group analysis testing the structural model.
The hypothesized structural model presented in Figure 1 was evaluated with BMI
being controlled as a covariate in this model. For women aged 18-24, this structural
60
model provided an adequate (RMSEA = .07) to excellent (χ2/df= 2.42, CFI = .97, TLI =
.96, SRMR= .05) fit to the data. Similarly, for women aged 25-79, this model provided
an adequate (RMSEA = .06) to excellent (χ2/df= 2.23, CFI = .98, TLI = .97, SRMR= .05)
fit to the data. Path coefficients are presented in Figure 2 for women aged 18-24 and in
Figure 3 for women aged 25-79. For both age groups, all hypothesized paths were
significant except for the path from general unconditional acceptance (i.e.,
conceptualized and measured as social support) to emphasis on body function. Therefore,
in order to obtain a more parsimonious and potentially better fitting model, this
nonsignificant path was deleted in the model for both age groups.
For women aged 18-24, this revised, more parsimonious model provided an
adequate (RMSEA = .07, SRMR = .06) to excellent (χ2/df= 2.53, CFI = .97, TLI = .96) fit
to the data. The version of the structural model containing the path from general
unconditional acceptance conceptualized as social support to emphasis on body function
did not provide a better fit to the data than the trimmed model, χ2 difference (1, N= 307) =
0.947, ns. Thus, this trimmed model was interpreted. Interpretation of this revised and
trimmed model suggested that approximately 10.7% of the variance in body function was
explained by perceived body acceptance by others, 25.1% of the variance in perceived
body acceptance by others was explained by general unconditional acceptance
conceptualized as social support, 68.5% of the variance in body appreciation was
explained by body function and perceived body acceptance by others, and 40.1% of the
variance in intuitive eating was explained by body appreciation and body function.
For women aged 25-79, the revised, more parsimonious model (i.e., without the
61
path from general unconditional acceptance to body function) provided an adequate
(RMSEA = .06) to excellent (χ2/df= 2.21, CFI = .98, TLI = .97, SRMR = .05) fit to the
data. The version of the structural model containing the path from general unconditional
acceptance conceptualized as social support to emphasis on body function did not provide
a better fit to the data than the trimmed model, χ2 difference (1, N= 381) = 0.052, ns. Thus,
this trimmed model was interpreted. Interpretation of this revised and trimmed model
suggested that approximately 8.2% of the variance in body function was explained by
perceived body acceptance by others, 52.5% of the variance in perceived body
acceptance by others was explained by general unconditional acceptance conceptualized
as social support, and 66.6% of the variance in body appreciation was explained by body
function and perceived body acceptance by others, and 46.7% of the variance in intuitive
eating was explained by body appreciation and body function.
4.3 Multiple Group Analysis and Test of Model Invariance
A latent variable SEM multiple group analysis was also run in order to determine
whether the factor structure identified in the structural model of Figure 1 would fit data
from the older and younger groups equally well. This multiple group analysis of model
invariance compared the fit of the model factor structure across the two age groups;
thereby garnering evidence as to whether the seven structural pathways illustrated in
Figure 1 differed significantly between older and younger participants. In the first, less-
restrictive multiple group analysis, the values of the structural paths were allowed to vary
the structural paths. In other words, the values of the structural paths were not fixed to be
equivalent so as to potentially suggest different structural paths for the two groups. In the
62
second, more restrictive multiple group analysis, the structural paths were constrained to
be invariant, meaning that the values of the structural paths were fixed to be equal for
both groups. During both analyses, factor loadings were held invariant between the two
groups so that constructs would be measured similarly for the older and younger groups.
The test of the first, less-restrictive model in which the structural paths are not
fixed to be equivalent (i.e., are allowed to vary) revealed that the model provided an
adequate (RMSEA=.07, SRMR=.06) to excellent (χ2/df =2.55, CFI=.97, TLI=.96) fit to
the data. The test of the second, more restrictive model in which the structural paths are
constrained to be equivalent suggested that the model did not provide an adequate fit to
the data (χ2/df =8.05, SRMR =.31, RMSEA=.14, CFI= .84, TLI=.82) to fit to the data.
Further, results indicated that the less restrictive model provided a significantly better fit
to the data than the restricted model, χ2 difference (23, N= 688) = 54.99, p<.01. These results
provide evidence to suggest that model invariance exists in the present study and that the
structural coefficients differ between older and younger women.
63
CHAPTER 5
DISCUSSION
5.1 Overview
The present study adds to extant literature on women�s body image and eating
disorder concerns by testing the posited pathways of an acceptance model of intuitive
eating (Avalos & Tylka, 2006) with a sample of women aged 25-79 and a comparison
sample of women aged 18-24. This model of intuitive eating has garnered support with
samples of predominantly traditionally-aged undergraduate women (Avalos & Tylka,
2006); however, the model of intuitive eating has not been examined with studies
specifically aiming to incorporate women older than the traditionally-aged college
student. Applications of this framework (including its hypothesized directional
pathways) with women aged across the adult lifespan is clearly needed. The present
study adds incrementally to existing research by attempting to further elucidate how
certain variables interact meaningfully to contribute to a positive body orientation and
adaptive intuitive eating behaviors in older and younger women.
5.2 Discussion of Findings from Latent Variable SEM
Upon initial analyses, the present study provided empirical evidence in support of
64
the acceptance model of intuitive eating as described by Avalos and Tylka (2006) among
women aged 18-24, as well as among women aged 25-79. Specifically, when the
proposed model of intuitive eating (see Figure 1) was tested independently with the
sample of younger women and the sample of older women, fit indices indicated that the
model provided an overall good fit to the data for both age groups of women. In
addition, all of the hypothesized pathways were significant except for the path from
general unconditional acceptance (i.e., conceptualized and measured as social support) to
emphasis on body function for both age groups. Therefore, in order to obtain a more
parsimonious and potentially better fitting model, this nonsignificant path was deleted
from the model before re-analyzing its fit with data from the younger sample and from
the older sample.
Once this nonsignificant pathway was removed from the model estimation, fit
statistics indicated an excellent fit of the revised model to the data for both age groups of
women (see Figure 2 for women 18-24; see Figure 3 for women 25-79). For women aged
18-24 in the present study, this revised, more parsimonious model accounted for 40.1%
of the variance in intuitive eating. For women aged 25-79 in the present study, this
revised, more parsimonious model accounted for 46.7% of the variance in intuitive
eating. For both older and younger women in the present study, these results indicate that
the basic model of intuitive eating fit the data, and that this model fit was significantly
improved with the deletion of the pathway from general unconditional acceptance to
body function. These findings provide further evidence to support the pathways of the
intuitive eating framework as posited by Avalos and Tylka (2006) as applied to samples
65
of predominantly young (i.e., 18-24) women. In addition, findings from older women in
the present study add incrementally to extant research by suggesting that the model of
intuitive eating may be generalized and extended to apply to women older than the
traditionally-aged undergraduate. Certainly though, continued research is needed to
determine whether such results are attributed as sample-specific. Therefore, the
importance of research attempting to replicate findings of the present study is
underscored. Findings and implications for both age groups of women from the present
study are discussed in more detail below.
5.21 General Unconditional Acceptance
In the present study, general unconditional acceptance (i.e., social support) was
found to predict perceived body acceptance by others in women aged 18-24 and in
women aged 25-79. These findings are consistent with theoretical assertions of the model
of intuitive eating and also offer empirical support for the pathway from general
unconditional acceptance to perceived body acceptance by others. Such results are also
consistent with, and add incrementally to, extant research findings linking general
unconditional acceptance to perceived body acceptance by others in samples of women
predominantly comprised of traditionally-aged undergraduates (i.e., Avalos & Tylka,
2006). Results from the present study lend support to the notion that when an older or
younger woman perceives general unconditional acceptance from her environment, she
may be more likely to perceive that others accept her body. Indeed, in the present study,
general unconditional acceptance was found to account for 25.1% of the variance in
perceived body acceptance by others for younger women. For older women of the
66
present study, general unconditional acceptance by others was found to account for
52.5% of the variance in perceived body acceptance by others. While both percentages
are significant, these findings also indicate the need to explore other variables that may
also be predicting perceived body acceptance by others and thereby accounting for some
of the remaining variance in this construct.
In comparing measured levels of general unconditional acceptance (i.e., social
support) for older and younger women in the present study, it is interesting to note that
women aged 25-79 years reported a significantly higher (p< .05) level of general
unconditional acceptance than younger women aged 18-24 years. It may be of value to
determine if such a finding may be replicated in other studies comparing older and
younger samples of women. Although this finding may be sample-specific, it may be
that older women of the present study have been better able to perceive a more accepting
environment and create more accepting social support networks with age and increased
distance from the pressures associated with remaining in the objectification limelight
(Fredrickson & Roberts, 1997).
It is also worth noting that while the significance of the pathway from general
unconditional acceptance to body acceptance by others for both groups of women in the
present study offers further support to that garnered by Tylka and Avalos (2006) for this
pathway, the present study utilized a different conceptualization and scale to measure
general unconditional acceptance than that employed by Avalos and Tylka (2006). The
scale used to measure general unconditional acceptance in the present study was designed
67
to measure the construct of perceived social support from influential others, while Avalos
and Tylka used a measure of women's perceptions of unconditional relational support
from the person they recognized as most important while growing up. It may be
interesting and useful for future studies to incorporate measures of several forms of
general unconditional acceptance (e.g., perceived social support from influential others,
perceived unconditional support from the most influential person while growing up), as
such different forms of general unconditional acceptance may each account for unique
variance in perceived body acceptance by others and further existing knowledge of this
link.
Another finding of interest garnered from the present study and related to the
construct of general unconditional acceptance (i.e., conceptualized and measured as
social support) was that it was not found to predict body function in women aged 18-24
or in women aged 25-79. This result is inconsistent with the theoretical underpinnings of
the model of intuitive eating and contrary to the hypothesis of the present study, both of
which posit that perceptions of general unconditional acceptance would allow women to
be more likely to focus on body function and inner experiences rather than adopting
external rules of eating (e.g., dieting) associated an emphasis on body appearance rather
than body function. The finding that general unconditional acceptance did not predict
body function in the present study is consistent, however, with past findings reported by
Avalos and Tylka (2006) from their sample of mostly traditionally-aged undergraduate
females.
68
In attempting to explain the unexpected nonsignificance of the path from general
unconditional acceptance to body function, Avalos and Tylka (2006) suggested that
perhaps rather than general unconditional acceptance, a more specific form (i.e., body
acceptance by others) of unconditional acceptance is the more powerful predictor of
emphasis on body function. This potentially viable explanation seems to be consistent
with findings that perceived body acceptance by others predicted emphasis on body
function in the present study as well as in previous research (i.e., Avalos & Tylka, 2006).
It is also conceivable that the conceptualization and/or measurement utilized in extant
literature have/has not sufficiently paralleled the theoretical construct of general
unconditional acceptance. Further research could help to provide more support for either
of these potentially plausible explanations for the unexpected finding that perceived
general unconditional acceptance did not predict emphasis on body function for either
age group of women.
5.22 Body Acceptance by Others
For women aged 18-24 in the present study, body appreciation by others was
found to predict a significant amount of unique variance (i.e., 10.7%) in emphasis on
body function. Body appreciation by others was also found to predict a significant
amount of variance (i.e., 8.2%) in body function for women aged 25-79 in the present
study. These findings are consistent with the hypothesis of the present study, as well as
with past findings derived from samples of mostly traditionally-aged female
undergraduates (Avalos& Tylka, 2006). Such results provide support for the supposition
behind the acceptance model of intuitive eating theory (Avalos & Tylka, 2006) that
69
women who perceive that their bodies are appreciated by others may be less preoccupied
with thoughts of attaining the thin ideal and may instead be better able to focus on the
functioning and internal experiences of their body.
Analyses of the present study also revealed that younger women reported
significantly higher (p<.05) levels of perceived body acceptance by others as compared
to older women. Older women of the present study also endorsed significantly higher
(p<.05) BMI reports, as well. In the present study it may be that younger women�s
bodies are closer approximations of the thin ideal, which is associated with their
perceptions of higher levels of body acceptance from others. If this is finding is
replicated, it may be of interest to examine women�s thoughts and feelings about growing
further from the thin ideal as they age. Further research could attempt to replicate and
explore such potential associations.
The present study�s empirical support of the pathway from body acceptance by
others to emphasis on body function also lends credence to a similar, but more
pathologically-focused vein of research findings in which a lack of body acceptance by
others may lead women to engage in more frequent habitual body monitoring which is
characteristic of an emphasis on body appearance rather than body function (Fredrickson
& Roberts, 1997). Finally, the present study's support for the link between body
acceptance by others and body function is consistent with extant research suggesting that
perceived pressure for thinness from others has been associated with women's tendency
to focus on outward body appearance rather than body function (e.g., Birch et al., 2003;
70
Carper et al., 2000; Tylka & Hill, 2004). Again, the significance of this pathway for both
groups of women in the present study replicates extant findings from samples of mostly
younger women (i.e., Avalos & Tylka, 2006) and also adds incrementally by offering
tentative support of the generalizability of this pathway with women older than the
traditionally-aged undergraduate.
Also consistent with hypothesized pathways of the present study is the finding
that the construct of body acceptance by others predicted a significant portion of unique
variance in body appreciation for women aged 18-24, as well as for women aged 25-79.
These findings offer further empirical support for the underlying assertion of the model
of intuitive eating that a woman who perceives that others are accepting of her body may
herself be more likely to endorse positive feelings towards her body such as body
appreciation. Again, this result is also congruent with past findings supporting the link
between body acceptance by others and body appreciation in samples of predominantly
traditionally-aged female undergraduates (i.e., Avalos & Tylka, 2006) and also provides
preliminary evidence for the applicability of this link in samples of women aged older
than the traditionally-aged undergraduate. In addition, the present study's support for the
association between body acceptance by others and body appreciation also builds upon
extant research underscoring the impact that others' opinions may have on feelings
towards one's own body (Tantleff-Dunn & Gokee, 2002). Finally, this finding seems to
offer a complimentary perspective to more pathologically-focused line of research
indicating that perceived pressure from others for thinness (in lieu of perceived body
71
acceptance by others) predicts body dissatisfaction above and beyond that accounted for
by habitual body monitoring.
5.23 Body Function
For both groups of women aged 18-24 and 25-79 in the present study, the
construct of body function was also found to predict a significant amount of the variance
in body appreciation. This finding is consistent with theory behind the model of intuitive
eating which posits that a woman�s tendency to emphasize her body�s functionality over
appearance may lead her to endorse higher levels of appreciation of her body. These
findings are once again congruent with hypotheses of the present study, as well as with
past research supporting the link between body function and body appreciation in
samples of mostly traditionally-aged female undergraduates (Avalos & Tylka, 2006). It
appears this link may be extended to apply to women aged older than the traditionally-
aged undergraduate; however, future research should attempt to replicate such findings
with other samples of older women.
In addition, the present study found that older women aged 25-79 years endorsed
significantly higher (p<.05) levels of viewing their bodies in terms of functionality rather
than appearance as compared to younger women aged 18-24 years. This finding seems
consistent with previous research (e.g., Greenleaf, 2005; McKinley, 1999) in which older
women reported significantly lower levels of body surveillance than younger women;
however, the present study adds incrementally by utilizing a different measurement and
conceptualization that stems from a more strength-based approach.
72
In the present study, the construct of body function was also found to predict a
significant amount of unique variance in intuitive eating for both groups of older and
younger women. This finding provides further support for similar findings in extant
research with undergraduate women (i.e., Avalos & Tylka, 2006) and suggests that this
pathway may be significant for older women, as well. This finding is also congruent with
the theoretical contentions and the model of intuitive eating suggesting that women who
emphasize body functionality over appearance may be more apt to eat for the purpose of
aiding one�s body functioning by honoring one�s internal hunger and satiety signals
(Tribole & Resch, 1995; Tylka, 2006). Finally, such results of the present study lend a
complimentary perspective to extant research in which habitual body monitoring of
appearance predicted disordered eating among women, above and beyond that explained
for by body shame (Moradi, Dirks, & Matteson, 2005).
5.23 Body Appreciation
In the present study, body appreciation was found to predict a significant amount
of unique variance in intuitive eating for women aged 18-24 and for women aged 25-79.
This finding is consistent with previous research linking body appreciation to intuitive
eating behavior in samples of predominantly traditionally-aged undergraduate women
(Avalos & Tylka, 2006), as well as consistent with assertions underlying the model of
intuitive eating (Avalos et al., 2005; Tribole & Resch, 1995) suggesting that women who
respect and appreciate their bodies may be more aware and respectful of their bodily
needs, including their internal hunger and satiety cues. In addition, such findings from the
73
present study enhance complimentary research demonstrating that women who do not
demonstrate body appreciation (i.e., have high levels of body dissatisfaction/ shame) also
endorsed higher levels of disordered eating (e.g., Moradi et al., 2005; Stice et al., 1996;
Tylka & Hill, 2004; Tylka & Subich, 2004). Hence, body appreciation was hypothesized
predict intuitive eating, and support for this pathway was ascertained for both younger
and older women in the present study.
5.24 Summary
For both younger and older women in the present study, the model of intuitive
eating (Avalos & Tylka, 2006; see Figure 1) provided a good fit to the data. Support was
garnered in both younger and older samples for all of pathways of the model of intuitive
eating except for the pathway from general unconditional acceptance to body function.
Once this nonsignificant pathway was removed from the model, further analyses
indicated that this more parsimonious model provided a significantly better fit to the data
for older and younger women. These findings replicate results reported by Avalos and
Tylka (2006) for their sample of predominantly traditionally-aged female undergraduates.
Further, findings from the present study provide much needed evidence suggesting that
the model of intuitive eating also appears to hold for women aged older than the
traditionally-aged undergraduate. Certainly though, future research is needed to continue
exploration of this topic and provide empirical evidence regarding the revised model of
the present study.
74
5.3 Discussion of Multiple Group Analyses and Test of Model Invariance
Findings from a latent variable SEM multiple group analysis with a test of model
invariance indicated that the factor structure identified in the structural model of Figure 1
did not fit data from the older and younger groups equally well. Indeed, findings offer
empirical evidence suggesting that the seven structural pathways illustrated in Figure 1
differed significantly between older and younger participants. Findings from the test of
the first, less-restrictive model in which the structural paths are not fixed to be equivalent
(i.e., are allowed to vary) revealed that the model provided an adequate to excellent fit to
the data, whereas findings from the test of the second, more restrictive model in which
the structural paths are constrained to be equivalent suggested that the model did not
provide an adequate fit to the data. Results also revealed that the less restrictive model
provided a significantly better fit to the data than the restricted model. Taken together,
results suggest that model invariance exists in the present study. In other words, the
present study has garnered evidence to suggest that the structural coefficients and factor
structure specified by the model of intuitive eating differ between older and younger
women. Future research and follow-up analyses could be conducted in order to ascertain
potential differences in construct means, to identify which pair or pairs of structural
coefficients were significantly different from one another, or to examine
mediation/indirect effects.
75
5.4 Limitations Although the present study contributes incrementally to extant literature, several
limitations should be addressed. First, participants were solicited through snowball
sampling methods using electronic email and online survey completion. While Internet
data collection may be helpful in recruiting a more diverse sample of women, it may also
be prone to inattentive responding, duplicate surveys, and random responding. While
several methods were employed to reduce erroneous data, such methods may not have
been able to completely eliminate fallacious data.
Additionally, more research is needed to compare Internet data collection with
other methods of data collection. Extant research (e.g., Koch & Emrey, 2001) has
suggested that Internet data collection may be beneficial for recruiting from hard-to-reach
populations. Research (Koch & Emrey, 2001) has also supported the demographic
comparability of samples recruited via the Internet with samples recruited via other
methods, as well as demographic similarities between those who chose to participate and
those who did not participate in Internet surveys. However, until additional research
provides more specific and repeated findings related to such issues, a limitation of the
present study may be sample bias, missing data, and/or limited ability to generalize
findings to the population of women across the lifespan.
An additional limitation is the self-report nature of all of the instruments of the
present study. Self-report data may be prone to inaccurate memories of participants,
influence of social desirability, and other related concerns that may result in erroneous
data. Another limitation of the present study is that the method of latent variable SEM
76
chosen to analyze the data is embedded in correlational methodology. Accordingly, no
firm causal conclusions may be made about the order of the variables. Although evidence
from the present study suggested that the model should be revised to exclude the pathway
from general unconditional acceptance to body function, this final model was data-
derived as opposed to theory-based, and other variables may have fit within the model as
well. For that matter, other models may have fit the data as well as the presented models.
Hence, support for the fit of the revised model should not be taken as evidence that the
model has been proven to be accurate. Rather, the models should be considered tentative
until additional research can determine whether findings related to the models may be
generalized to other samples. Future research should attempt to replicate findings of the
present study with more diverse samples, instrumentation, and/or methodologies.
Another potential limitation of the present study is the cross-sectional design. A
related limitation is the rather age group classification. With no clear suggestions for age
group classifications apparent in extant literature on eating and body image concerns, the
present study relied on previously-established age group cut-off delineating traditionally-
aged undergraduates from those older than the traditionally-aged undergraduate.
However, as much variance exists within both age groups, the present categorization may
not be as sensitive to similarities and differences within groups. Also, due to the cross-
sectional methodology, age effects could be attributed to cohort differences, or
generational effects. For example, Grogan (1999) suggests that women aged 50 and older
may have experienced less pressure for thinness, as the fuller figures of Marilyn Monroe
and Jayne Mansfield were more representative of the cultural ideal of attractiveness.
77
Also, as research and educational programming related to body image and eating disorder
concerns has only fairly recently begun to receive increasing attention by society at large,
it is conceivable that younger women may have had more education about the etiology,
treatment, and prevention of eating disorders. A longitudinal study would be a logical
extension of the present study and an attempt to explore developmental changes with age.
Future research should extend the present study by drawing from samples that are
more representative of the general population, especially with regard to education.
Overall, the participants of the present study appeared to be highly educated, which may
limit the appropriateness of generalizing findings and applicability to women with less
education. Extensions of the present study should attempt to draw a sample of women
more representative of the general population.
5.7 Future Research
Future research should attempt to replicate the present study�s findings with
samples that are more representative of the general population (e.g., with regard to
education). Future research should also examine the role of additional variables (e.g.,
personal, psychological, relational correlates) within the model. The inclusion of
additional variables within the model may serve to elucidate factors that contribute to
development of positive body image and more adaptive eating behaviors. Finally, it is
imperative to continue examining the body image and eating behaviors of women aged
across the adult lifespan. The present study offers evidence to suggest although the basic
model of intuitive eating applies to older and younger women, these constructs interact
differently for women across the adult lifespan. Although a solid foundation of literature
78
addressing age in relation to body image and eating disorder concerns has yet to be
established, the present study adds incrementally by replicating the applicability of a
model based on intuitive eating with a sample of traditionally-aged undergraduate
women, as well as suggesting that this model may also be generalized to apply to women
aged older than the traditional undergraduate. The present study offers a framework for
understanding the body and eating experiences of women aged 18-79; however, it is
essential to continue to apply, integrate, and extend findings of the present study in
pursuit of a better understanding of women of all ages.
79
REFERENCES
Altabe, M. & Thompson, J. (1993). Body image changes during early adulthood. International Journal of Eating Disorders, 13, 323-328. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders,(4th ed.). Washington, D.C: Author. Avalos, L., Tylka, T.L. (2006). Exploring a Model of Intuitive Eating With College
Women. Journal of Counseling Psychology, 53, 486-497.
Avalos, L., Tylka, T.L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Development and psychometric evaluation. Body Image: An International Journal of Research, 2, 285-297.
Bentler, P.M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238-246.
Ben-Tovim, D. I., & Walker, M.K. (1994). The influence of age and weight on women�s body attitudes as measured by the Body Attitudes Questionnaire (BAQ). Journal of Psychosomatic Research, 38, 477-481.
Birch, L.L., Fisher, J.O., & Davison, K.K. (2003). Learning to overeat: Maternal use of restrictive feeding practices promotes girls� eating in the absence of hunger. American Journal of Clinical Nutrition, 78, 215-220.
Birch, L.L., Johnson, S.L., Andresen, G., Petersen, J.C., & Schulte, M.C. (1991). The variability of young children�s energy intake. New England Journal of Medicine, 324, 232-235.
Browne, M.W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K.A.
Bollen & J.S. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park, CA: Sage.
80
Carper, J.L., Fisher, J.O., & Birch, L.L. (2000). Young girls� emerging dietary restraint And disinhibition are related to parental control in child feeding. Appetite, 35, 121-129.
Cutrona, C. E., & Russell, D. (1987). The provisions of social relationships and adaptation to stress. In W. H. Jones & D. Periman (Eds.), Advances in personal relationships (Vol. 1, pp. 37-67). Greenwich, CT: JAI Press.
Cutrona, C. E., & Russell, D. (1990). Type of social support and specific stress: Toward a theory of optimal matching. In I. G. Sarason, B. R. Sarason, & G. R. Pierce (Eds.), Social support: An interactional view (pp. 319-366). New York: Wiley.
Cutrona, Russell, & Rose, 1986. Social support and adaptation to stress by the elderly. Psychology and Aging, 1, 47-54.
Davis, C., & Cowles, M.(1991). Body image and exercise: A study of relationships and comparisons between physically active men and women. Sex Roles, 25, 33-44.
Faith, M.S., Scanlon, K.S., Birch, L.L., Francis, L.A., & Sherry, B. (2004). Parent-child feeding strategies and their relationships to child eating and weight status. Obesity Research, 12, 1711-1722.
Feingold, A., & Mazella, R. (1998). Gender differences in body image are increasing. Psychological Science, 9, 190-195.
Fodor, I.G., & Franks, V. (1990). Women in midlife and beyond: The new prime of life? Psychology of Women Quarterly, 14, 445-449.
Franzoi, S., & Sheilds, S. (1984). The body esteem scale: Multidimensional structure and sex differences in a college population. Journal of Personality Assessment, 48, 173-178.
Frazier, P.A., Tix, A.P., & Barron, K.E. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51, 115-134.
Fredrickson, B. L., & Roberts, T.-A. (1997). Objectification theory: Toward
understanding women's lived experiences and mental health risks. Psychology of Women Quarterly, 21,173-206.
Garner, D.M. (1997). The 1997 body image survey results. Psychology Today, 30 (January/February), 30-44, 75-80, 84.
81
Garner, D.M., & Garfinkel, P.E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273-279.
Garner, D.M., Olmsted, M.P., & Polivy, V. (1983). Development and validation of a
multidimensional eating disorder inventory for anorexia nervosa and bulimia, International Journal of Eating Disorders, 2(2), 15-34.
Gelso, C., & Fretz, B. (2001). Counseling psychology (2nd ed.). Fort Worth, TX:
Harcourt. Greenleaf, C. (2005). Self-objectification among physically active women, Sex Roles,
52(1-2), 51-62.
Gergen, M.M. (1990). Finished at 40: Women's development with partriarchy. Psychology of Women Quarterly, 14, 471-493.
Greenleaf, C. (2005). Self-objectification among physically active women, Sex Roles, 52(1-2), 51-62.
Grogan, S. (1999). Body image. London: Routledge. Gurman, A.S. (1977). The patient�s perspective of the therapeutic relationship. In A.S.
Gurman & A.M. Razin (Eds.), Effective psychotherapy: A handbook of research (pp. 503-543). New York: Pergamon Press.
Hawks, S., Merrill, R.M., & Madanat, H.N. (2004). The Intuitive Eating Scale: Development and preliminary validation. American Journal of Health Education, 35, 90-99.
Herzog, D. B., Dorer, D. J., Keel, P. K., Selwyn, S. E., Ekeblad, E. R., Flores, A. T., Greenwood, D. N., Burwell, R. A., & Keller, M. B. (1999). Recovery and relapse in anorexia an bulimia nervosa: A 7.5-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 38 (7), 829-837.
Hetherington, M.M., & Burnett, L. (1994). Ageing and the pursuit of slimness: Dietary Restraint and weight satisfaction in elderly women. British Journal of Clinical Psychology, 33, 391-400.
Hill, M.S. (2003). Examining objectification theory: Sexual objectification's link with self-objectification and moderation by sexual orientation and age in White women. Dissertation Abstracts International: Section B: The Sciences & Engineering,63(7-B).
82
Hotelling, K. (2001). At last! Counseling psychology and eating disorders. Counseling Psychologist, 29, 733-742.
Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55.
Hund, A.R., & Espelage, D.L. (2005). Childhood sexual abuse, disordered eating, alexithymia, and general distress: A mediation model. Journal of Counseling Psychology, 52, 559-573.
Kahn, J.H. (2006). Factor analysis in counseling psychology research, training, and
practice: principles, advances, and applications. Counseling Psychologist, 34, 684-718.
Kashubeck-West, S., & Mintz, L.B. (2001). Eating disorders in women: Etiology,
assessment, and treatment. Counseling Psychologist, 29, 627-634. Kelloway, E.K. (1998). Using LISREL for structural equation modeling. Thousand Oaks,
CA: Sage.
Lewis, M. (1992). Shame: The exposed self. New York: Free Press. Lewis, D. M., & Cachelin, F. M. (2001) Body image, body dissatisfaction and eating
attitudes in midlife and elderly women. Eating Disorders, 9, 29-39.
Liao, H-Y., Rounds, J., & Klein, A.G. (2005). A test of Cramer's (1999) help-seeking model and acculturation effects with Asian/Asian American college students. Journal of Counseling Psychology, 52, 400-411.
Long, B.C. (1998). Coping with workplace stress: a multiple group comparison of femalemanagers and clerical workers. Journal of Counseling Psychology,45, 65-78.
Mallinckrodt, B. & Wei, M. (2005). Attachment, social competencies, social support, and psychological distress. Journal of Counseling Psychology, 52, 358-367.
Mazzeo, S.E., & Espelage, D.L. (2002). Association between childhood physical and emotional abuse and disordered eating behaviors in female undergraduates: An investigation of the mediating role of alexithymia and depression. Journal of Counseling Psychology, 49, 86-100.
83
McKinley, N.M. (1999). Women and objectified body consciousness: Mothers' and daughters' body experience in cultural, developmental, and familial context. Developmental Psychology, 35, 760-769.
McKinley, N. M., & Hyde, S. (1996). The Objectified Body Consciousness Scale: Development and validation. Psychology of Women Quarterly, 20, 181-215.
Mintz, L.B., & Betz, N.E. (1988). Prevalence and correlates of eating disordered behaviors among undergraduate women. Journal of Counseling Psychology, 44, 463-471.
Mitchell, V. & Helson, R. (1990). Women's prime of life: Is it the 50s? Psychology of Women Quarterly, 14, 451-470.
Moradi, B., Dirks, D., & Matteson, A.V. (2005). Roles of sexual objectification experiences and internalization of standards of beauty in eating disorder symptomatology: A test and extension of objectification theory. Journal of Counseling Psychology, 52, 420-428.
Muth, J.L., & Cash, T.F. (1998). Body image attitudes: What difference does gender make? Journal of Applied Social Psychology, 27, 1438-1452.
Muthén, L.K., & Muthén, B.O. (2001). Mplus user�s guide (2nd ed.). Los Angeles: Muthén & Muthén.
Muthén, L.K., & Muthén, B.O. (2006). Mplus user�s guide (4th ed.). Los Angeles: Muthén & Muthén.
Nauta, M.M., Epperson, D.L., & Kahn, J.H. (1998). A multiple group analysis of predictors of higher level career aspirations among women in mathematics, science, and engineering majors. Journal of Counseling Psychology, 45, 483-496.
Neugarten, B.L., Wood, V., Kraines, R.J., & Loomis, B., (1963). Women's attitudes
towards menopause. Vita Humana, 6, 140-151. Noll, S.M., & Fredrickson, B.L. (1998). A mediational model linking self
objectification, body shame, and disordered eating. Psychology of Women Quarterly, 22, 623-636.
Parlee, M.B. (1984). Reproductive issues, including menopause. In G. Baruch & J. Brooks-Gunn (Eds.), Women in midlife (pp. 303-313). New York: Plenum.
84
Pearson, J., Goldklang, D., & Striegel-Moore, R. H. (2002). Prevention of eating disorders: Challenges and opportunities. International Journal of Eating Disorders, 31, 233-239.
Pliner, P., Chaiken, S., & Flett, G.L. (1990). Gender differences in concern with body weight and physical appearance over the life span. Personality and Social Psychology Bulletin, 16, 263-273.
Polivy, J., & Herman, C.P. (1999). Distress and eating: Why do dieters overeat?
International Journal of Eating Disorders, 26, 153-164.
Rand, C.S., & Kuldau, J.M. (1991). Restrained eating (weight concerns) in the general population and among students. International Journal of Eating Disordersm 10, 699-708.
Rogers, C.R. (1961). On becoming a person. Boston, MA: Houghton Mifflin. Rogers, C.R. (1964). Toward a modern approach to values: The valuing process in the
mature person. Journal of Abnormal and Social Psychology, 68, 160-167.
Rozin, P. & Fallon, A. (1988). Body image, attitudes to weight, and misperceptions of figure preferences of the opposite sex: A comparison of men and women in two generations. Journal of Abnormal Psychology, 97, 342-345. Russell, D.W., Kahn, J.H., Spoth, R., & Altmaier, E.M. (1998). Analyzing data from
experimental studies: A latent variable structural equation modeling approach. Journal of Counseling Psychology, 45, 18-29.
Seligman, M.E., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5-14.
Stokes, R.,& Frederick-Recascino, C. (2003). Women�s perceived body image: Relations with personal happiness. Journal of Women and Aging, 15, 17-29. Stice, E., Nemeroff, C., & Shaw, H. (1996). Test of the dual pathway model of bulimia
nervosa: Evidence for dietary restraint and affect regulation mechanisms. Journal of Social and Clinical Psychology, 15, 340-363.
Striegel-Moore, R.H, Silberstein, L.R., & Rodin, J. (1986). Toward an understanding of the risk factors for bulimia, American Psychologist, 41, 246-263.
Striegel-Moore, R.H., Tucker, N., & Hsu, J. (1990). Body image dissatisfaction and disordered eating in lesbian college students. International Journal of Eating
Disorders, 9, 493-500.
85
Strunkard, A., Sorenson, T., Schulsinger, F.(1980). Use of the Danish Adoption Register
for the study of obesity and thinness. In S. Kety, L.P. Rowland, L. Sidman, & S.W. Matthysse (Eds.) The genetics of neurological and psychological disorders (pp. 115-120). New York: Raven Press.
Tabachnick, B.G., & Fidell, L.S. (1996). Using multivariate statistics (3rd ed.). New York: HarperCollins.
Tantleff-Dunn, S.G., & Gokee, J.L. (2002). Interpersonal influences on body image
development. In T.F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 108-116). New York: Guilford.
Tiggemann, M., & Lynch, J.E. (2001). Body image across the life span in adult women: The role of self-objectification, Developmental Psychology, 37(2):243-53.
Tribole, E., & Resch, E. (1995). Intuitive eating: A recovery book for the chronic dieter. New York: St. Martin�s Press.
Tylka, T.L. (2006). Development and psychometric evaluation of a measure of intuitive
eating. Journal of Counseling Psychology, 53, 226-240. Tylka, T.L., & Hill, M.S. (2004). Objectification theory as it relates to disordered eating
among college women. Sex Roles, 51, 719-730.
Tylka, T.L., & Subich, L.M. (2004). Examining a multidimensional model of eating
disorder symptomatology among college women. Journal of Counseling Psychology, 51, 314-328.
Tylka, T.L. & Wilcox, J. (2006). Are intuitive eating and eating disorder symptomatology
opposite poles of the same construct? Journal of Counseling Psychology, 53, 474-485.
Wilcox, J. (2006). Construct validity for the Barrett-Lennard Relationship Inventory with college women. Unpublished manuscript.
Wonderlich, S.A., Joiner, T.E., Keel, P.K., Williamson, D.A., & Crosby, R.D. (2007).
Eating disorder diagnoses: empirical approaches to classification. American Psychologist, 62, 167-180.
86
APPENDIX A
DESCRIPTION OF STUDY (HOSTED ON WEBSITE)
87
Thoughts, feelings, and experiences concerning body image
Welcome! WOMEN AGED 18 AND OLDER ONLY!
WOMEN AGED 30 AND OLDER ARE ESPECIALLY ENCOURAGED TO
PARTICIPATE, although women aged 18-29 are also welcome.
This survey is part of a study examining women's relationships with others, body attitudes, and eating habits. If you choose to participate, this study will take you
approximately 15 minutes. This study is anonymous; therefore, your responses will be confidential. Other than what you voluntarily submit in response to the survey, no
information or software will be taken from or left on your computer, no tracking methods will be used to collect information, upload �cookies,� or do anything else that might
compromise your privacy. By submitting responses you give your consent to participate.
I ask that you respond honestly to all questions as best you can, as the validity of the study will depend on your honest answers.
At any point during the experiment, you can withdraw your participation without penalty or repercussion by closing out of your browser. If you have questions or concerns about
this research, feel free to contact me. My name is Casey Augustus-Horvath, and my email address is [email protected]. My faculty advisor is Dr. Tracy Tylka. Please feel
free to also contact her if you have questions about this study. She is an assistant professor at The Ohio State University at Marion. Her phone number is 740-389-6786 x
6384, and her email address is [email protected].
Thank you for your time!
I am a woman aged 18 or older.________ I consent to participate and would like to begin the questionnaire now. ___________
88
APPENDIX B
ELECTRONIC MAIL DESCRIPTION
89
Hello!
My name is Casey Augustus-Horvath, and I am a graduate student in the Counseling Psychology Ph.D. Program in the Department of Psychology at The Ohio State University. I am the principle investigator for a research study examining women's attitudes about women's relationships with others, body attitudes, and eating habits. Women aged 30 and older are especially encouraged to participate, but women aged 18-29 are also welcome.
If you choose to participate in this study, please click on the link at the bottom of the page. The survey will take approximately 15 minutes to complete. Due to the nature of Internet research, the security of the survey data during transmission cannot be guaranteed; however, no identifying information will be collected. Your responses are completely anonymous. Security is guaranteed once the researcher receives the data.
If you would like further information about this study, please do not hesitate to contact me at [email protected]. You may also contact my advisor Dr. Tracy Tylka at [email protected]. The methods of this research and the plan for protection of rights of participants have been reviewed and approved by the Office of Responsible Research Practices, which oversees all research conducted at The Ohio State University. This plan received Institutional Review Board approval on day and time (Project # 2004#####). Please feel free to forward this email to other women who may be interested in participating.
If you have read this email and would like to take the survey, please click on the URL below:
http://www.surveymonkey.com/s.asp?u=##########
Thank you for your time!
Casey L. Augustus-Horvath
90
APPENDIX C
SOCIAL PROVISIONS SCALE
91
Instructions: In answering the following questions, think about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people. Use the following scale to indicate your opinion.
1 2 3 4 Strongly disagree Disagree Agree Strongly agree
So, for example, if you feel a statement is very true of your current relationships, you would respond with a 4 (strongly agree). If you feel a statement clearly does not describe your relationships, you would respond with a 1 (strongly disagree).
1. There are people I can depend on to help me if I really need it. 2. I feel that I do not have close personal relationships with other people.* 3. There is no one I can turn to for guidance in times of stress.* 4. There are people who depend on me for help. 5. There are people who enjoy the same social activities I do. 6. Other people do not view me as competent.* 7. I feel personally responsible for the well-being of another person. 8. I feel part of a group of people who share my attitudes and beliefs. 9. I do not think other people respect my skills and abilities.* 10. If something went wrong, no one would come to my assistance.* 11. I have close relationships that provide me with a sense of emotional security and
well-being. 12. There is someone I could talk to about important decisions in my life. 13. I have relationships where my competence and skill are recognized. 14. There is no one who shares my interests and concerns.* 15. There is no one who really relies on me for their well-being.* 16. There is a trustworthy person I could turn to for advice if I were having problems. 17. I feel a strong emotional bond with at least one other person. 18. There is no one I can depend on for aid if I really need it.* 19. There is no one I feel comfortable talking about problems with.* 20. There are people who admire my talents and abilities. 21. I lack a feeling of intimacy with another person.* 22. There is no one who likes to do the things I do.* 23. There are people who I can count on in an emergency. 24. No one needs me to care for them.*
Scoring:
• Asterisked item � * � should be reversed.
92
APPENDIX D
OBJECTIFIED BODY CONSCIOUSNESS SCALE:
BODY SURVEILLANCE SUBSCALE
93
1.) I rarely think about how I look.(R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 2.) I think it is more important that my clothes are comfortable than whether they look good on me. (R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 3.) I think more about how my body feels than how my body looks. (R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 4.) I rarely compare how I look with how other people look. (R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 5.) During the day, I think about how I look many times. 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 6.) I often worry about whether the clothes I am wearing make me look good. 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 7.) I rarely worry about how I look to other people. (R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree 8.) I am more concerned with what my body can do than how it looks. (R) 1 2 3 4 5 6 7 NA Strongly Disagree Neither Agree Nor Disagree Strongly Agree
94
APPENDIX E
BODY ACCEPTANCE BY OTHERS SCALE
95
For each item, please circle the response that best captures your own experience.
1. I�ve felt acceptance from my friends regarding my body shape and/or weight. 1 2 3 4 5
Never Rarely Sometimes Often Always
2. My friends have sent me the message that my body shape and weight are fine.
1 2 3 4 5 Never Rarely Sometimes Often Always
3. I�ve felt acceptance from my family regarding my body shape and/or weight. 1 2 3 4 5
Never Rarely Sometimes Often Always
4. My family has sent me the message that my body shape and weight are fine. 1 2 3 4 5
Never Rarely Sometimes Often Always
5. I�ve felt acceptance from people I�ve dated regarding my body shape and/or weight.
1 2 3 4 5 Never Rarely Sometimes Often Always
6. People I�ve dated have sent me the message that my body shape and weight are fine.
1 2 3 4 5 Never Rarely Sometimes Often Always
7. I�ve felt acceptance from the media (e.g., TV, magazines) regarding my body shape and/or weight.
1 2 3 4 5 Never Rarely Sometimes Often Always
8. I feel that the media have sent me the message that my body shape and weight are fine.
1 2 3 4 5 Never Rarely Sometimes Often Always
96
9. I�ve felt acceptance from society (e.g., school, church, social settings) regarding my body shape and/or weight.
1 2 3 4 5 Never Rarely Sometimes Often Always
10. I feel that society has sent me the message that my body shape and weight are fine.
1 2 3 4 5 Never Rarely Sometimes Often Always
97
APPENDIX F
BODY APPRECIATION SCALE
98
Please indicate whether the question is true about you never, seldom, sometimes, often, or always.
1. I respect my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
2. I feel good about my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
3. On the whole, I am satisfied with my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
4. Despite its flaws, I accept my body for what it is. 1 2 3 4 5
Never Seldom Sometimes Often Always
5. I feel that my body has at least some good qualities. 1 2 3 4 5
Never Seldom Sometimes Often Always
6. I take a positive attitude towards my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
7. I am attentive to my body�s needs. 1 2 3 4 5
Never Seldom Sometimes Often Always
8. My self worth is independent of my body shape or weight. 1 2 3 4 5
Never Seldom Sometimes Often Always
99
9. I do not focus a lot of energy being concerned with my body shape or weight. 1 2 3 4 5
Never Seldom Sometimes Often Always
10. My feelings toward my body are positive, for the most part. 1 2 3 4 5
Never Seldom Sometimes Often Always
11. I engage in healthy behaviors to take care of my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
12. I do not allow unrealistically thin images of women presented in the media to affect my attitudes toward my body.
1 2 3 4 5 Never Seldom Sometimes Often Always
13. Despite its imperfections, I still like my body. 1 2 3 4 5
Never Seldom Sometimes Often Always
100
APPENDIX G
INTUITIVE EATING SCALE
101
Directions for participants: For each item, please circle the answer that best characterizes your attitudes or behaviors. 1. I try to avoid certain foods high in fat, carbohydrates, or calories.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 2. I stop eating when I feel full (not overstuffed).
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 3. I find myself eating when I’m feeling emotional (e.g., anxious, depressed, sad), even when I’m not physically hungry.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 4. If I am craving a certain food, I allow myself to have it.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 5. I follow eating rules or dieting plans that dictate what, when, how much to eat.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 6. I find myself eating when I am bored, even when I’m not physically hungry.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 7. I can tell when I’m slightly full.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 8. I can tell when I’m slightly hungry.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 9. I get mad at myself for eating something unhealthy.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 10. I find myself eating when I am lonely, even when I’m not physically hungry.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 11. I trust my body to tell me when to eat.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree
102
12. I trust my body to tell me what to eat. 1 2 3 4 5
Strongly Disagree Disagree Neutral Agree Strongly Agree 13. I trust my body to tell me how much to eat.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 14. I have forbidden foods that I don’t allow myself to eat.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 15. When I’m eating, I can tell when I am getting full.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 16. I use food to help me soothe my negative emotions.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 17. I find myself eating when I am stressed out, even when I’m not physically hungry.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 18. I feel guilty if I eat a certain food that is high in calories, fat, or carbohydrates.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 19. I think of a certain food as “good”or “bad” depending on its nutritional content.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 20. I don’t trust myself around fattening foods.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree 21. I don’t keep certain foods in my house/apartment because I think that I may lose control and eat them.
1 2 3 4 5 Strongly Disagree Disagree Neutral Agree Strongly Agree
103
APPENDIX H
DEMOGRAPHIC INFORMATION
104
Age: In what state do you live?_______ Your race/ethnicity: African American Asian American Caucasian/Euro American Native American Latina/Hispanic ______ International ______ Biracial ______ Multiracial Other: please specify: Your socio-economic status: Upper class Middle class Working class/Lower class
Other: please specify: Your Highest Education Level:
Completed graduate school Completed high school Some graduate school Some high school Completed college Completed middle school Some college Some middle school Other: please specify:________________________________________
Your rank, if currently in college: First Year Continuing Education Second Year Other:___________ Third Year Fourth Year
Fifth Year Relationship status: Single Married Long-term relationship ______ Widowed Divorced ______ Partnered
Other: please specify: ____________ How often you usually exercise for approximately 30 minutes of exercise per week: ______ One day or less 5-7 days per week
______ 2-4 days per week Other: if your exercise routine drastically differs from the options given, please specify:____________
Weight:______ Height______
Thank you!
105
APPENDIX I
106
________________________________________________________________________
Measure SPS BAOS BS BAS IES BMI M SD α
________________________________________________________________________
SPS 1 .42 * .06 .35* .21 * -.08 3.43 0.38 .92
BAOS 1 .26* .69* .44* -.21* 3.79 0.76 .91
BS 1 .53* .45* -.09 3.29 1.09 .83
BAS 1 .56* -.09 3.58 0.76 .93
IES 1 -.03 3.24 0.57 .87
________________________________________________________________________
Table 1 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body function, body appreciation, intuitive eating, and body mass for women aged 18-24. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale; BMI = Body Mass Index. n = 307. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
107
________________________________________________________________________
Measure SPS BAOS BS BAS IES BMI M SD α
________________________________________________________________________
SPS 1 .42* .10 .32* .22* -.18 3.55 0.38 .93
BAOS 1 .25* .65* .43* -.65* 3.48 0.71 .91
BS 1 .57* .44* -.07 3.53 1.19 .86
BAS 1 .60* -.48* 3.50 0.70 .93
IES 1 -.41* 3.15 0.61 .89
________________________________________________________________________
Table 2 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body function, body appreciation, intuitive eating, and body mass for women aged 25-79. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale; BMI = Body Mass Index. n = 381. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
108
________________________________________________________________________
Measure SPS BAOS BS BAS IES BMI M SD α
________________________________________________________________________
SPS 1 .37* .10 .32* .20* -.09 3.50 0.38 .92
BAOS 1 .23* .66* .44* -.47* 3.62 0.75 .91
BS 1 .54* .43* .02 3.42 1.15 .85
BAS 1 .58* -.30* 3.54 0.73 .93
IES 1 -.26* 3.19 0.59 .88
________________________________________________________________________
Table 3 Mean scores, standard deviations, alpha levels, and intercorrelations among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for all women in the study. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale. n = 688. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
109
_______________________________________________________________________
Measure SPS BAOS BS BAS IES
________________________________________________________________________
SPS 1 .42* .06 .34* .21*
BAOS 1 .29* .69* .45*
BS 1 .54* .46*
BAS 1 .56*
IES 1
________________________________________________________________________
Table 4 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for women aged 18-24. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale. n = 307. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
110
_______________________________________________________________________
Measure SPS BAOS BS BAS IES
________________________________________________________________________
SPS 1 .40* .09 .27* .16
BAOS 1 .26* .50* .24*
BS 1 .60* .45*
BAS 1 .51*
IES 1
________________________________________________________________________
Table 5 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for women aged 25-79. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale. n = 381. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
111
_______________________________________________________________________
Measure SPS BAOS BS BAS IES
________________________________________________________________________
SPS 1 .38* .10 .31* .18
BAOS 1 .26* .57* .38*
BS 1 .57* .45*
BAS 1 .55*
IES 1
________________________________________________________________________
Table 6 Partial correlations with body mass index controlled among measures of social support, body acceptance by others, body function, body appreciation, and intuitive eating for all women in the study. Note. SPS = Social Provisions Scale; BAOS = Body Acceptance by Others Scale; BS = Body Surveillance subscale of the Objectified Body Consciousness Scale; BAS = Body Appreciation Scale; IES = Intuitive Eating Scale. n = 688. Absolute correlation values at or above .20 are interpreted as statistically and practically significant and denoted with an asterisk (Walsh & Betz, 2001).
112
Var
iabl
e
M
SD
1
2
3
4
5
6
7
8
9 1
0 11
12
1
3
14
1
5
1. S
PS1
3
.34
.3
8
--
--
.81
.
83
.0
4
-.02
.0
6
.36
.4
0
.34
.
26
.3
5
.25
.
09
.13
.
15
2. S
PS2
3
.44
.40
---
-
.83
.
13
.04
.08
.3
6
.43
.3
4
.32
.42
.
32
.22
.
22
.27
3. S
PS3
3.41
.42
----
.
07
-.02
.
05
.32
.
39
.35
.25
.
33
.2
6
.17
.1
9
.18
4. B
S1
3
.42
1.27
----
.
63
.61
.2
2
.29
.2
9
.50
.44
.
54
.43
.
46
.44
5. B
S2
3
.15
1.19
---
- .
60
.18
.1
9
.21
.
44
.3
4
.42
.
29
.33
.
28
6. B
S3
3.51
1.3
0
---
- .
19
.24
.
24
.3
8
.38
.47
.2
9
.33
.2
7
7. B
AO
S1
3.9
6
.81
----
.9
0
.77
.
54
.6
1
.58
.
31
.36
.
38
Tabl
e 7
Mea
ns, s
tand
ard
devi
atio
ns, a
nd p
artia
l cor
rela
tions
(with
bod
y m
ass
inde
x co
ntro
lled)
am
ong
parc
els
for w
omen
age
d 18
-24
Not
e. N
= 3
07. A
bsol
ute
corr
elat
ion
valu
es g
reat
er th
an o
r equ
al to
.20
indi
cate
s pra
ctic
al s
igni
fican
ce a
nd st
atist
ical
sig
nific
ance
at p
<.0
01. S
PS (S
ocia
l Sup
port)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e So
cial
Pro
visio
ns S
cale
; BS
(Bod
y Fu
nctio
n) 1
, 2,
3 =
thre
e pa
rcel
s fro
m th
e O
bjec
tifie
d B
ody
Con
scio
usne
ss (O
BC
) Bod
y Su
rvei
llanc
e Sc
ale;
BA
OS
(Bod
y A
ccep
tanc
e by
O
ther
s) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ccep
tanc
e by
Oth
ers S
cale
; BA
S (B
ody
App
reci
atio
n) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ppre
ciat
ion
Scal
e; IE
S (I
ntui
tive
Eatin
g) 1
, 2, 3
= th
ree
parc
els
from
the
Intu
itive
Eat
ing
Scal
e.
112
113
Var
iabl
e
M
SD
1
2
3
4
5
6
7
8
9 1
0 11
12
1
3
14
1
5
8. B
AO
S2
3.9
8
.81
----
.7
8
.57
.68
.
64
.32
.
40
.42
9. B
AO
S3
3.5
0
.82
---
-
.60
.
64
.6
4
.35
.4
3
.48
10. B
AS1
3
.54
.7
8
----
.
83
.8
2
.47
.4
8
.55
11. B
AS2
3.73
.
80
--
--
.86
.
40
.43
.
52
12. B
AS3
3
.49
.8
3
-
---
.47
.
50
.57
13. I
ES1
3.11
.
63
--
--
.80
.7
4
14. I
ES2
3.
04
.63
---
- .
77
15. I
ES3
3.5
6
.58
--
--
Tabl
e 7,
con
tinue
d M
eans
, sta
ndar
d de
viat
ions
, and
par
tial c
orre
latio
ns (w
ith b
ody
mas
s in
dex
cont
rolle
d) a
mon
g pa
rcel
s fo
r wom
en a
ged
18-2
4
Not
e. N
= 3
07. A
bsol
ute
corr
elat
ion
valu
es g
reat
er th
an o
r equ
al to
.20
indi
cate
s pra
ctic
al s
igni
fican
ce a
nd st
atist
ical
sig
nific
ance
at p
<.0
01. S
PS (S
ocia
l Sup
port)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e So
cial
Pro
visio
ns S
cale
; BS
(Bod
y Fu
nctio
n) 1
, 2,
3 =
thre
e pa
rcel
s fro
m th
e O
bjec
tifie
d B
ody
Con
scio
usne
ss (O
BC
) Bod
y Su
rvei
llanc
e Sc
ale;
BA
OS
(Bod
y A
ccep
tanc
e by
O
ther
s) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ccep
tanc
e by
Oth
ers S
cale
; BA
S (B
ody
App
reci
atio
n) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ppre
ciat
ion
Scal
e; IE
S (I
ntui
tive
Eatin
g) 1
, 2, 3
= th
ree
parc
els
from
the
Intu
itive
Eat
ing
Scal
e.
113
114
Var
iabl
e
M
SD
1
2
3
4
5
6
7
8
9 1
0 11
12
1
3
14
1
5
1. S
PS1
3
.56
.3
8
---
-
.83
.8
4
.09
.
07
.10
.
34
.31
.
36
.2
3
.21
.23
.0
8
.14
.1
5
2. S
PS2
3
.54
.41
---
-
.85
.
07
.08
.
11
.34
.
31
.36
.26
.
23
.3
0
.13
.1
8
.17
3. S
PS3
3
.57
.4
0
--
--
.06
.
06
.09
.
31
.28
.
33
.2
3
.19
.23
.0
9
.15
.1
6
4. B
S1
3
.15
1
.26
--
--
.73
.6
6
.16
.2
4
.23
.
59
.5
5
.41
.
37
.37
.
40
5. B
S2
4
.06
1
.34
----
.6
3
.14
.1
9
.19
.
52
.5
1
.35
.
34
.34
.
34
6. B
S3
3.29
1
.48
---
- .
20
.26
.
26
.5
4
.50
.38
.3
6
.38
.3
9
7. B
AO
S1
3.7
9
.79
----
.5
3
.61
.
37
.4
2
.40
.
15
.19
.
23
Tabl
e 8
Mea
ns, s
tand
ard
devi
atio
ns, a
nd p
artia
l cor
rela
tions
(with
bod
y m
ass
inde
x co
ntro
lled)
am
ong
parc
els
for w
omen
age
d 25
-79
N
ote.
N =
381
. Abs
olut
e co
rrel
atio
n va
lues
gre
ater
than
or e
qual
to .2
0 in
dica
tes p
ract
ical
sig
nific
ance
and
stat
istic
al
signi
fican
ce a
t p <
.001
. SPS
(Soc
ial S
uppo
rt) 1
, 2, 3
= th
ree
parc
els
from
the
Soci
al P
rovi
sions
Sca
le; B
S (B
ody
Func
tion)
1, 2
, 3
= th
ree
parc
els
from
the
Obj
ectif
ied
Bod
y C
onsc
ious
ness
(OB
C) B
ody
Surv
eilla
nce
Scal
e; B
AO
S (B
ody
Acc
epta
nce
by
Oth
ers)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e B
ody
Acc
epta
nce
by O
ther
s Sca
le; B
AS
(Bod
y A
ppre
ciat
ion)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e B
ody
App
reci
atio
n Sc
ale;
IES
(Int
uitiv
e Ea
ting)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e In
tuiti
ve E
atin
g Sc
ale.
114
115
Var
iabl
e
M
SD
1
2
3
4
5
6
7
8
9 1
0 11
12
1
3
14
1
5
8. B
AO
S2
3.0
2
.84
---
- .9
1
.41
.42
.
38
.17
.
21
.23
9. B
AO
S3
3.3
2
.77
--
--
.41
.
43
.3
9
.15
.2
0
.25
10. B
AS1
3
.42
.7
4
----
.
79
.7
2
.48
.4
8
.48
11. B
AS2
3.48
.
77
--
--
.78
.
40
.42
.
45
12. B
AS3
3.63
.7
4
-
---
.3
5
.36
.3
4
13. I
ES1
3.1
5
.72
--
--
.74
.7
5
14. I
ES2
3
.28
.6
0
-
---
.74
15. I
ES3
3.0
2
.68
--
--
Tabl
e 8,
con
tinue
d M
eans
, sta
ndar
d de
viat
ions
, and
par
tial c
orre
latio
ns (w
ith b
ody
mas
s in
dex
cont
rolle
d) a
mon
g pa
rcel
s fo
r wom
en a
ged
25-7
9
Not
e. N
= 3
81. A
bsol
ute
corr
elat
ion
valu
es g
reat
er th
an o
r equ
al to
.20
indi
cate
s pra
ctic
al s
igni
fican
ce a
nd st
atist
ical
sig
nific
ance
at p
<.0
01. S
PS (S
ocia
l Sup
port)
1, 2
, 3 =
thre
e pa
rcel
s fro
m th
e So
cial
Pro
visio
ns S
cale
; BS
(Bod
y Fu
nctio
n) 1
, 2,
3 =
thre
e pa
rcel
s fro
m th
e O
bjec
tifie
d B
ody
Con
scio
usne
ss (O
BC
) Bod
y Su
rvei
llanc
e Sc
ale;
BA
OS
(Bod
y A
ccep
tanc
e by
O
ther
s) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ccep
tanc
e by
Oth
ers S
cale
; BA
S (B
ody
App
reci
atio
n) 1
, 2, 3
= th
ree
parc
els
from
the
Bod
y A
ppre
ciat
ion
Scal
e; IE
S (I
ntui
tive
Eatin
g) 1
, 2, 3
= th
ree
parc
els
from
the
Intu
itive
Eat
ing
Scal
e.
115
11
6
1
2
3
4
5
1. G
ener
al U
ncon
ditio
nal A
ccep
tanc
e
----
-
2. B
ody
Acc
epta
nce
by O
ther
s
.
46*
----
-
3. E
mph
asis
on B
ody
Func
tion
.0
6
.
28*
---
--
4. B
ody
App
reci
atio
n
.3
8*
.72
*
.
60*
--
---
5. In
tuiti
ve E
atin
g
.2
3*
.4
5*
.52*
.6
0*
--
---
Tabl
e 9
Cor
rela
tions
am
ong
the
late
nt v
aria
bles
on
the
basi
s of t
he m
easu
rem
ent m
odel
for w
omen
age
d 18
-24
year
s.
Not
e. N
= 3
07. A
bsol
ute
corr
elat
ion
valu
es d
enot
ed b
y an
ast
erisk
are
gre
ater
than
or e
qual
to .2
0, w
hich
indi
cate
s pra
ctic
al
signi
fican
ce a
nd st
atist
ical
sig
nific
ance
at p
<.01
.
116
11
7
1
2
3
4
5
1. G
ener
al U
ncon
ditio
nal A
ccep
tanc
e
----
-
2. B
ody
Acc
epta
nce
by O
ther
s
.
41*
---
--
3. E
mph
asis
on B
ody
Func
tion
.1
1
.26*
--
---
4. B
ody
App
reci
atio
n
.3
3*
.6
4*
.63*
---
--
5. In
tuiti
ve E
atin
g
.2
4*
.
45*
.49
*
.6
5*
--
---
Tabl
e 10
C
orre
latio
ns a
mon
g th
e la
tent
var
iabl
es o
n th
e ba
sis o
f the
mea
sure
men
t mod
el fo
r wom
en a
ged
25-7
9 ye
ars.
N
ote.
N =
381
. Abs
olut
e co
rrel
atio
n va
lues
den
oted
by
an a
ster
isk a
re g
reat
er th
an o
r equ
al to
.20,
whi
ch in
dica
tes p
ract
ical
sig
nific
ance
and
stat
istic
al s
igni
fican
ce a
t p<.
01.
117
11
8
Gen
eral
U
ncon
ditio
nal
Acc
epta
nce
(SPS
)
Bod
y A
ccep
tanc
e by
Oth
ers
(BA
OS)
B
ody
Func
tion
(OB
C B
ody
Surv
eilla
nce)
Bod
y A
ppre
ciat
ion
(BA
S)
In
tuiti
ve E
atin
g (I
ES)
a
b c
d
e
fg
Figu
re 1
. Hyp
othe
sized
mod
el il
lust
ratin
g th
e pr
edic
tion
of in
tuiti
ve e
atin
g (A
valo
s & T
ylka
, 200
6).
118
11
9 Fi
gure
2. P
arce
l loa
ding
s fo
r the
mea
sure
men
t mod
el a
nd p
ath
coef
ficie
nts
for t
he tr
imm
ed st
ruct
ural
mod
el o
btai
ned
by
anal
yzin
g th
e da
ta fr
om w
omen
age
d 18
-24
(n =
307
) usin
g la
tent
var
iabl
e st
ruct
ural
equ
atio
n m
odel
ing.
Sta
ndar
d er
rors
wer
e .0
1, .0
5, a
nd .0
5 fo
r the
gen
eral
unc
ondi
tiona
l acc
epta
nce
item
par
cels
(SPS
); .0
1, .0
3, a
nd .0
4 fo
r the
bod
y ac
cept
ance
by
othe
rs it
em p
arce
ls (B
AO
S); .
01, .
06, a
nd .0
7 fo
r the
bod
y fu
nctio
n ite
m p
arce
ls (B
S); .
01, .
04, a
nd .0
5 fo
r the
bod
y ap
prec
iatio
n ite
m p
arce
ls (B
AS)
; and
.00,
.05,
and
.05
for t
he in
tuiti
ve e
atin
g ite
m p
arce
ls (I
ES).
*p <
.05.
\
Gen
eral
U
ncon
ditio
nal
Acce
ptan
ce
Body
Ac
cept
ance
by
Oth
ers
Body
Func
tion
Body
App
reci
atio
n I
ntui
tive
Eatin
g.4
5*
.32*
.42*
.47*
.23*
SPS
1SP
S2
SPS
3
.92*
BAO
S1
BAO
S2 BA
OS3
.93*
IES1
IES3
IES2
.83*
96* .9
0*.9
0*
.91*
.86*
.87*
BAS
2 BA
S3
BAS
1
.88*
.93*
.9
3*
BS
1
BS
2
BS
3
.84*
.76*
.74*
.61*
119
12
0
Figu
re 3
. Par
cel l
oadi
ngs
for t
he m
easu
rem
ent m
odel
and
pat
h co
effic
ient
s fo
r the
trim
med
stru
ctur
al m
odel
obt
aine
d by
an
alyz
ing
the
data
from
wom
en a
ged
25-7
9 (n
= 3
81) u
sing
late
nt v
aria
ble
stru
ctur
al e
quat
ion
mod
elin
g. S
tand
ard
erro
rs w
ere
.01,
.04,
and
.04
for t
he g
ener
al u
ncon
ditio
nal a
ccep
tanc
e ite
m p
arce
ls (S
PS);
.01,
.07,
and
.06
for t
he b
ody
acce
ptan
ce b
y ot
hers
item
par
cels
(BA
OS)
; .01
, .06
, and
.06
for t
he b
ody
func
tion
item
par
cels
(BS)
; .01
, .04
, and
.04
for t
he b
ody
appr
ecia
tion
item
par
cels
(BA
S); a
nd .0
1, .0
4, a
nd .0
4 fo
r the
intu
itive
eat
ing
item
par
cels
(IES
). *p
<.0
5.
Gen
eral
U
ncon
ditio
nal
Acce
ptan
ce
Body
Ac
cept
ance
by
Oth
ers
Body
Func
tion
Body
App
reci
atio
n I
ntui
tive
Eatin
g.2
9*
.37*
.52*
.40*
.22*
SPS
1SP
S2
SPS
3
.93*
BAO
S1
BAO
S2
BAO
S3
.75*
IES1
IES3
IES2
.99*
95*.9
1*.9
2*
.89*
.88*
.88*
BAS
2BA
S3
BAS
1
.89*
.93*
.87*
BS
1
BS
2
BS
3
.88*
.82*
.77*
.37*
120